DOPPLER STUDY IN HIGH-RISK PREGNANCIES IN THIRD TRIMESTER OF PREGNANCIES FOR PREDICTION OF ADVERSE PERINATAL OUTCOME

Background: Doppler ultrasound has emerged as beneficial tool in the assessment of the fetal and placental circulation and in the prediction of adverse pregnancy outcome. Umbilical artery Doppler has proved helpful to supervise the growth restricted fetuses and compromised vasculature as in hypertensive disorders high risk pregnancies. Objective of present study was to investigate the association between third-trimester uterine artery Doppler assessment and adverse obstetric outcome.Methods: This prospective study was done among 110 high risk pregnancies. Vessel like uterine artery, umbilical artery, middle cerebral artery and ductus venosus were studied in present study. Indices calculated: Peak systolic velocity, End diastolic velocity, Mean velocity, Systolic/diastolic ratio, Pulsatility index (PI) and resistance index (RI) of middle cerebral artery (MCA), Ductus venosus S/A ratio.Results: bilateral notch was present statistically significant (p<0.05) in 18.1% and absent in 28.2% among cases of adverse perinatal outcome. UA S/D ratio was >3 in 22.7% and <3 in 11.8% among cases of adverse perinatal outcome and findings were statistically significant (p<0.05). End diastolic velocity was reduced in statistically significant (p<0.05) in 9.1% and normal in 20.1% among cases of adverse perinatal outcome. MCA PI was <lower limit statistically significant (p<0.05) in 24.5% and >lower limit in 18.2% among cases of adverse perinatal outcome. MCA PI/UA PI ratio was <1 statistically significant (p<0.05) in 25.5% and absent in 17.3% among cases of adverse perinatal outcome.Conclusions: Increase in UA PI and decrease in MCA PI are early marker for detection of fetal compromise. Ratio of indices between MCA PI and UA PI reflects brain sparing effect as well as placental insufficiency and these are more specific in detection of IUGR than individual artery indices.

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P79 Value of third trimester uterine artery Doppler for prediction of adverse perinatal outcome in high risk pregnancies

International Journal of Gynecology & Obstetrics ◽

10.1016/s0020-7292(09)61570-8 ◽

2009 ◽

Vol 107 ◽

pp. S433-S434

Author(s):

L. Rai ◽

L. Shivananda

Keyword(s):

High Risk ◽

Perinatal Outcome ◽

Uterine Artery ◽

Third Trimester ◽

Uterine Artery Doppler ◽

Adverse Perinatal Outcome

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Value of Third Trimester Uterine Artery Doppler in High-risk Pregnancies for Prediction of Adverse Perinatal Outcome

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1056 ◽

2010 ◽

Vol 2 (1) ◽

pp. 31-35 ◽

Cited By ~ 3

Author(s):

Lavanya Rai ◽

S Lekshmi

Keyword(s):

High Risk ◽

Gestational Age ◽

Perinatal Outcome ◽

Uterine Artery ◽

Umbilical Artery ◽

Perinatal Morbidity ◽

Third Trimester ◽

Uterine Artery Doppler ◽

Adverse Perinatal Outcome ◽

Umbilical Artery Doppler

ABSTRACT Objective To determine the usefulness of uterine artery Doppler in evaluation of third trimester high-risk pregnancies in prediction of adverse perinatal outcome. Methods In this prospective study uterine artery Doppler parameters such as PI and early diastolic notch were recorded in a group of 60 high-risk pregnancies mainly consisting of pre-eclampsia and small for gestational age. Uterine artery score (UAS) was calculated from the Doppler parameters and a score ≥ 2 was considered abnormal. Perinatal outcome was then correlated to this score and compared with umbilical artery Doppler. Results Abnormal UAS was noted in 72% of the study group while umbilical artery Doppler was abnormal in only 35%. All the five perinatal deaths and high-rate of perinatal morbidity was observed when both uterine and umbilical artery Dopplers were abnormal. Perinatal morbidity parameters such as birth weight < 2 kg, gestational age < 34 weeks and NICU admission was significantly high in 23 women who had abnormal UAS with normal umbilical artery Doppler. In pregnancies beyond 34 weeks abnormal uterine artery Doppler was a better predictor of adverse outcome than umbilical artery Doppler. Conclusion Abnormal uterine artery Doppler is a reliable predictor of adverse perinatal outcome in high-risk pregnancies with preeclampsia and fetal growth restriction. Normal uterine artery Doppler in third trimester is reassuring. Thus inclusion of uterine artery Doppler along with umbilical artery Doppler in high-risk pregnancy in third trimester will improve fetal surveillance.

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417: Cerebro-placental ratio at third trimester screening as a predictor of adverse perinatal outcome

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2018.11.438 ◽

2019 ◽

Vol 220 (1) ◽

pp. S283

Author(s):

Alicia Alvarez ◽

Daniel Oros ◽

Pilar Calvo-Carod ◽

Maria Guarga ◽

Sara Ruiz-Martinez ◽

...

Keyword(s):

Perinatal Outcome ◽

Third Trimester ◽

Adverse Perinatal Outcome ◽

Trimester Screening

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Determinants of adverse perinatal outcome in high-risk women with abnormal uterine artery Doppler images

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2007.09.031 ◽

2008 ◽

Vol 198 (3) ◽

pp. 330.e1-330.e7 ◽

Cited By ~ 60

Author(s):

Meghana Toal ◽

Sarah Keating ◽

Geoff Machin ◽

Jodie Dodd ◽

S. Lee Adamson ◽

...

Keyword(s):

High Risk ◽

Perinatal Outcome ◽

Uterine Artery ◽

Uterine Artery Doppler ◽

High Risk Women ◽

Adverse Perinatal Outcome

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A Randomized Controlled Study to assess the Role of Routine Third Trimester Ultrasound in Low-risk Pregnancy on Antenatal Interventions and Perinatal Outcome

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1292 ◽

2014 ◽

Vol 6 (3) ◽

pp. 139-143 ◽

Cited By ~ 1

Author(s):

Hema Dhumale ◽

Yeshita Pujar ◽

Komal Gurunath Revankar

Keyword(s):

High Risk ◽

Perinatal Outcome ◽

Low Risk ◽

Controlled Study ◽

Third Trimester ◽

Randomized Controlled ◽

Risk Pregnancy ◽

Low Risk Pregnancy ◽

And Control

ABSTRACT Objective To assess the role of routine third trimester ultrasound in low-risk pregnancy on antenatal interventions and perinatal outcome. Design Randomized controlled study. Setting KLES Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum. Subjects A total of 290 low-risk pregnant women between 34 and 37 weeks attending antenatal clinic and fulfilling inclusion criteria were allotted using computer-generated randomization numbers into study and control groups. Intervention In study group, third trimester ultrasound was performed to assess fetal growth, amniotic fluid index (AFI), malpresentations, and late onset fetal anomalies. In control group, no routine ultrasound was performed, unless indicated by clinical suspicion during subsequent visits. High-risk fetuses identified were managed as per the standard protocol. All women were followed to assess antenatal interventions, intrapartum events and perinatal outcome. Results Detection of high-risk fetuses antenatally in study and control groups was 17.25 and 2.07% respectively. This difference was statistically significant (p = —0.0001). Rates of antenatal interventions among study and control were 24.8 and 4.44% respectively. Prevalence of small for gestational age (SGA) fetuses among study and control was 6.9 vs 11.03% respectively. This difference was not statistically significant (p = —0.253). There was no statistical difference in adverse intrapartum events, cesarean section rate for nonreassuring cardiotocography (CTG), low Apgar score and neonatal intensive care unit (NICU) admissions among study and controls. Conclusion Routine third trimester ultrasound is a logical solution for detection of high-risk fetuses in low-risk pregnancies which would otherwise be missed by clinical examination. However, this leads to an increase in antenatal interventions without significantly influencing the perinatal outcome. How to cite this article Revankar KG, Dhumale H, Pujar Y. A Randomized Controlled Study to assess the Role of Routine Third Trimester Ultrasound in Low-risk Pregnancy on Antenatal Interventions and Perinatal Outcome. J South Asian Feder Obst Gynae 2014;6(3):139-143.

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