scholarly journals “Early Screening Test for High Risk Pregnancies by Second Trimester Color Doppler Imaging Of the Feto-Placental Circulation”

2021 ◽  
Vol 8 (09) ◽  
pp. 5615-5620
Author(s):  
Pratima Rani Biswas ◽  
Gautom Kumar Paul ◽  
Mahmuda Khatun ◽  
Mamata Manjuri ◽  
Samima Rahman
Keyword(s):  
High Risk ◽  
Early Detection ◽  
Screening Test ◽  
Umbilical Artery ◽  
Doppler Sonography ◽  
Color Doppler ◽  
P Value ◽  
Risk Pregnancy ◽  
Gestation Age ◽  
Umbilical Artery Doppler

Objective: To examine the diagnostic value of umbilical artery velocity waveforms for the early detection of pregnancy induced hypertension and fetal growth restriction. To determine the utility of color Doppler Sonography of the fetoplacetal circulation for early detection of high risk pregnancies. Methods: This prospective study was conducted in the Department of Obstetrics & Gynecology, Sir Sallimullah Medical Collage & Mitford Hospital Dhaka in collaboration with radiology and imaging department of Dhaka hospital in 1st July, 2006 to 30 June, 2008. 126 randomly selected patients from 17-35 years of ages whose umbilical artery Doppler sonography was done between 16-22 weeks of gestation.  All the patient were taken umbilical artery Doppler ultrasonography. Informed consent was taken from all patients. Results: A total 126 subjects of 16 to 22 weeks of gestation were included in this series. On application of the student‘t’ test for S/D ratio between normal and abnormal waveforms of the umbilical artery was found significant difference (P<.0001). Distribution of patient according to umbilical artery systolic / diastolic ratio (n=126). Normal UA waveform 76 (60%), abnormal UA waveform 50(40%), Age (Mean ±SD) in year, normal UA waveform 25.63 ± 4.47 and abnormal UA waveform 25.86±3.75. Para: Primiparous normal UA waveform 36 (60%) & abnormal UA waveform 24 (40%), multiparous normal UA waveform 40 (60.6%) & abnormal UA waveform 26 (39.4%). Gestation age at scan in weeks (Mean± SD), normal UA waveform 19.5 ±2.5, abnormal UA waveform 19±2.0. Gestation age at delivery in weeks (Mean± SD), normal UA waveform 39.03±1.61, abnormal UA waveform 35.78 ±1.53, P value 0.0001. Birth wt. in Kg. (Mean ±SD), normal UA waveform 3.10 ±0.38, abnormal UA waveform 2.42 ±0.53, P value 0.0001. S/D ratio (Mean ±SD), normal UA waveform 2.40 ±0.31, abnormal UA waveform 5.46±1.62, P value 0.0001. Cases with an abnormal outcome in relation to whether the umbilical artery waveform was classified as normal or abnormal (n=126). Abnormal outcome in PIH normal UA waveform (n=76) 4%, PIH abnormal UA waveform (n=50) 14%, P value 0.001. In PIH/FGR, normal UA waveform (n=76) 1% & abnormal UA waveform (n=50) 5%, P value 0.024. FGR normal UA waveform (n=76) 5% & abnormal UA waveform (n=50) 13%, P value 0.002. Asphyxia normal UA waveform (n=76) 0% & abnormal UA waveform (n=50) 3%, P value 0.017. PIH /IUD normal UA waveform (n=76) 0% & abnormal UA waveform (n=50) 1%.   A significant association was found when the Chi Square (X 2) test was used to examine the relationship between umbilical artery blood flow and the outcome of patient (i.e FGR, PIH, fetal asphyxia). The screening test had a sensitivity of 78.26% & specificity of 82.5% and accuracy 80.95%. The predictive value of a positive test was 72% and of a negative test 86.84%. Conclusion : A close linear relationship between diagnosis of high risk pregnancy & umbilical artery Doppler velocity waveforms was observed .As umbilical artery Doppler is easy to perform and it is done in between 16 to 22 weeks of gestation can be done along with anomaly scan which is also done at 20-22 week of gestation. So, UA Doppler does not cause additional USG scan. Along with anomaly scan UA Doppler will help to screen out high risk pregnancy.

scholarly journals Doppler Velocimetry evaluation in high-risk pregnancy for prediction of Preeclampsia

2021 ◽  
Vol 12 (10) ◽  
pp. 135-141
Author(s):  
Rohini Singh ◽  
Sudipa Mondal ◽  
Manisha Bajaj ◽  
Debasmita Mandal
Keyword(s):  
High Risk ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Doppler Velocimetry ◽  
Third Trimester ◽  
Uterine Artery Doppler ◽  
Risk Pregnancy ◽  
Patients At Risk ◽  
Umbilical Artery Doppler ◽  
Doppler Indices

Background: The uterine and umbilical artery Doppler scan is a valuable tool for evaluation of utero-placental blood flow in pregnancy. They help in detecting uteroplacental insufficiency thus predicting preeclampsia and other effects of faulty placentation which increase the risk of adverse effects on both mother and fetus. Aims and Objective: This study aimed to evaluate and compare the uterine artery and umbilical artery Doppler indices in second and third trimester for prediction of preeclampsia in high-risk pregnancies. Materials and Methods: In this prospective observational study done over a years’ time, 50 high-risk pregnant mothers were recruited and the Doppler scans were done at 21-25 weeks and 31-35 weeks. The necessary clinical observations were recorded throughout the antenatal period and the data analysis was done. Results: Majority (56%) were in 20-29 years range with mean age of 24±6.1 years. Out of the 50 women, 21 had abnormal uterine artery Doppler and 12 had umbilical artery abnormality along with uterine derangement. Preeclampsia developed in 3 of them. The hypertensive disorders of pregnancy were diagnosed in 13 women, preeclampsia in 3, eclampsia in 1and other HDPs in 9. The persistence of notch in uterine artery was observed in 7 women, of these 2 developed PIH. Only one patient had uterine artery PI>1.45 at 24 weeks who subsequently developed preeclampsia. Among 4 patients of preeclampsia and eclampsia, 3 had 2nd trimester uterine and 3rd trimester umbilical Doppler abnormalities and only 1 had normal doppler indices. In 2nd trimester the sensitivity, specificity and PPV are higher for uterine artery PI as compared to umbilical artery PI. Hence, uterine artery doppler seems to be a better screening tool for early prediction of PIH. The third trimester umbilical artery PI with higher specificity (96%) and PPV (50%) can diagnose preeclampsia better. One patient had absent diastolic flow and she developed preeclampsia and IUGR. The combined uterine and umbilical artery doppler is a better screening modality as it has a higher sensitivity (75%) and NPV (99.26%). Conclusion: The uterine and umbilical artery Doppler velocimetry are potential tools for uteroplacental surveillance of high-risk pregnancies which can identify patients at risk and help in taking timely action to prevent complications.

scholarly journals Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy

2018 ◽  
Vol 7 (2) ◽  
pp. 628
Author(s):  
Rashmi L. ◽  
Ashish Bhattacharjee
Keyword(s):  
High Risk ◽  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Fetal Outcome ◽  
High Risk Pregnancy ◽  
Doppler Velocimetry ◽  
Average Birth Weight ◽  
Risk Pregnancy ◽  
Umbilical Artery Doppler ◽  
Doppler Indices

Background: Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy. The aim of this study was to study the umbilical artery Doppler velocimetry in predicting the fetal outcome in high risk pregnancy. This is a prospective study done over a period of 1 year in Silchar Medical College and Hospital from 1st September 2011 to 31st August 2012. 100 women with singleton pregnancy with high risk admitted in SMCH were subjected to umbilical artery Doppler along with morphology and biometry scan after fulfilling the inclusion and exclusion criteria.Methods: 100 women with high risk pregnancy were evaluated by umbilical artery velocimetry between 28 and 41 weeks of pregnancy. Outcome of pregnancy was recorded for the normal Doppler group (n = 79; 79%), the low-end diastolic flow group (n = 19; 19%) and the group with absent/reversed diastolic flow (n = 2; 2%).Results: Mothers with abnormal velocimetry had more number of caesarean sections than those with normal velocimetry. The diagnosis to delivery interval, gestational age at delivery and average birth weight were comparatively lower with higher incidence of admission to neonatal intensive care unit in foetuses with abnormal umbilical Doppler velocimetry. Sensitivity, specificity, positive and negative predictive values of Doppler for detecting abnormal fetal outcome were 43%, 83%, 33% and 88% respectively. Statistical analysis used: sensitivity, specificity and predictive values.Conclusions: Fetuses with normal flow velocimetry are at lower risk than those with abnormal velocimetry in terms of poor Apgar score and neonatal intensive care admission. The average birth weight of the neonates with abnormal Doppler studies was lower than that of neonates with normal velocimetry. Doppler velocimetry studies of umbilical artery can provide the obstetrician important information regarding fetal wellbeing to help him improve fetal outcome. 

scholarly journals Comparison of modified biophysical profile and Doppler ultrasound in prediction of perinatal outcome in high-risk pregnancies

2020 ◽  
Vol 9 (7) ◽  
pp. 2808
Author(s):  
Khushboo Malhotra ◽  
Archana Kumari ◽  
H. P. Anand
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
P Value ◽  
Fisher Exact Test ◽  
Perinatal Complications ◽  
Singleton Pregnancy ◽  
Biophysical Profile ◽  
Umbilical Artery Doppler

Background: The objective of this present study was to compare MBPP and umbilical artery Doppler flow in high-risk pregnant women in prediction of perinatal outcome.Methods: A cohort study was done on 150 high-risk pregnant women over 16 months. Antenatal women with singleton pregnancy who delivered within 48 hours of performing MBPP and Doppler USG, with presence of ≥1 high-risk factor like pre-eclampsia/gestational HTN, BOH, post-dated pregnancy, FGR, GDM, maternal heart disease, anaemia, hypothyroidism and IHCP were included in the study. MBPP (NST and AFI) and umbilical artery Doppler was performed. Perinatal outcome was measured in terms of stillbirth/IUD, LBW, Apgar <7 at 5 minutes, admission to NICU, neonatal death within 48 hours of delivery, MSL and neonatal seizures within 24-48 hours. Quantitative variables were compared using independent t-test/Mann Whitney test. Qualitative variables were correlated using Chi square test/Fisher exact test. Sensitivity, specificity, NPV, PPV were calculated and p-value <0.05 was considered statistically significant. Data analysis was done using social sciences (SPSS) licensed version 21.0.Results: Majority belonged to the age group 21-25 years and were between 37-40 weeks of gestation. It was found that highest perinatal complications occurred in those with both abnormal MBPP and Doppler followed by those with only abnormal MBPP (p-value<0.0001).Conclusions: MBPP is a better predictor of perinatal outcome compared to umbilical artery Doppler USG in high-risk pregnant women. MBPP should be done in all high-risk pregnancies even if Doppler is normal. Both the tests must be performed in all high-risk pregnancies to improve perinatal outcome.

scholarly journals Role of color doppler ultrasonography in high risk pregnancies: a retrospective study

2019 ◽  
Vol 8 (12) ◽  
pp. 4915
Author(s):  
Gayak Kavitha ◽  
Nirupama Palakodeti ◽  
Silpahasa Samalla
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Doppler Ultrasonography ◽  
Umbilical Artery ◽  
Color Doppler ◽  
Color Doppler Ultrasonography ◽  
High Risk Pregnancy ◽  
Age Group ◽  
Risk Pregnancy

Background: Numerous adverse perinatal outcomes are associated with high-risk. The usage of doppler ultrasound bids a non-invasive way to study the fetal and maternal circulation and guide the clinical management. Objective of this study was to investigate the role of color doppler ultrasonography in effective management of high-risk pregnancies.Methods: A retrospective record-based study was carried out Department of obstetrics and gynecology. Record of antenatal women who belonged to the age group of 20-30 years with singleton pregnancy of gestational age of 26 weeks to term and presence of one of the high-risk factors were included in the study. The risk factors which were considered are pregnancy-induced hypertension (PIH), diabetes, anemia, oligohydramnios. Doppler study of umbilical artery was done. Epi-info 7 was used for analysis.Results: A total of 140 cases were studied in which high-risk pregnancy was most common in the age group of 20-25 years. The most common high-risk factor in pregnancy was PIH which accounted for 50% of cases. Out of 140 cases high-risk pregnancies, 40% of cases resulted in intrauterine growth restriction (IUGR). 43% of cases, umbilical artery findings were abnormal.Conclusions: Color doppler can be used as most effective for fetal surveillance in high-risk pregnancy cases. Most importantly it helps in guiding early intervention and improving fetal outcome.

scholarly journals Role of uterine and umbilical artery doppler assessment of the uteroplacental circulation in predicting pre-eclampsia: comparison between different doppler parameters

2017 ◽  
Vol 6 (10) ◽  
pp. 4314
Author(s):  
Vimla Dhakar ◽  
Sabiha Naz
Keyword(s):  
High Risk ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
High Sensitivity ◽  
High Risk Pregnancy ◽  
Trophoblast Invasion ◽  
Uterine Artery Doppler ◽  
Risk Pregnancy ◽  
Doppler Study ◽  
Umbilical Artery Doppler

Background: Hypertensive disorders are the common cause of maternal death which affecting nearly 5-10% of pregnancies all over the world. Pre-eclampsia develop from inadequate trophoblast invasion of the maternal spiral arteries and Doppler values permits non-invasive evaluation of uteroplacental circulation and is of great importance in the management of high risk pregnancies. The aim of the study was to assess the findings of Doppler data in predicting pre-eclampsia and comparison of the efficacy of uterine artery Doppler and umbilical artery Doppler.Methods: The study comprises of 100 women with high risk pregnancy attending antenatal clinic at Geetanjali Medical College and Hospital, Udaipur were subjected to uterine and umbilical artery Doppler Study. Women with high risk pregnancy between 26-32 weeks of gestation were studied with colour Doppler. This was a prospective study over a period of 1 year from 2015-2016.Results: The results of the study revealed that 5 out of 100 participants developed pre-eclampsia. Out of different parameters, notch is the best predictor of pre-eclampsia with high sensitivity and highest PPV for uterine artery Doppler and S/D ratio is considered to be best indicator for umbilical artery Doppler. Regarding efficacy, umbilical artery Doppler is more predictive than uterine Doppler.Conclusions: Doppler study can be used for the prediction of pre-eclampsia to reduce maternal morbidity and mortality.

scholarly journals Husban Behavior in Pregnancy-Postpartum Care and Wife’s Reproductive Health

2019 ◽  
Author(s):  
Rosmala Nur ◽  
Sulaiman Mamar ◽  
Indah Puspasari Kiay Demak ◽  
Fadhliah . ◽  
Nurhaya S. Patui ◽  
...  
Keyword(s):  
High Risk ◽  
Reproductive Health ◽  
Early Detection ◽  
Antenatal Care ◽  
Health Problems ◽  
Postpartum Care ◽  
P Value ◽  
Pregnancy Care ◽  
Risk Pregnancy ◽  
In Pregnancy

Background: In the process pregnancy-postpartum, the role of the husband is very important and necessary. It is highly expected for the husbands to accompany their wives, so that their wives can have healthy pregnancy which is later able to give birth a healthy baby and the mothers can survive. Objectives: The purpose of this study is to find out the effect of husband’s knowledge regarding Antenatal Care (ANC) and Early High-Risk Detection, husband behavior in the pregnancy-postpartum care with reproductive health problems experienced by wife and to determine which variable that has the greatest effect among the three variables. Metohdes: This research is an analytical observation, carried out in the working area of Tinggede Health Center which includes 3 villages namely Sunju, Tinggede and South Tinggede the research target is all husbands who have pregnant wife (second pregnancy) and have children under two years old with a total of 180 husbands. The survey was carried out on 180 husbands. Data collection is carried out through interviews, observations and FGDs. Data analysis technique with Chi Square value test (p <0.05). Results: The results showed that the level of husband’s knowledge about Antenatal Care and early detection of high risk was low, 58.88% and 56.66%, respectively. Husband behavior in pregnancy care was also categorized as less healthy/bad, i.e., 55.55%, and the prevalence of wife’s respondents who experienced reproductive health problems was 57.7%. Husband’s knowledge about ANC, early detection of high-risk pregnancy, and husband behavior in pregnancy care had a significant relationship to reproductive health problems (p<0.05). The highest frequency of husband’s participation in the pregnancy-postpartum care is making referrals to the healthcare facilities by 79%, Husband behavior in pregnancy care has the greatest effect on maternal reproductive health problems with a P value = 0.001. Conclusion: It can be concluded that the husband’sknowledgeregardingANCandearlydetectionofpregnancyandpostpartum periodhasaneffectonmaternalreproductivehealthinSigiRegency, CentralSulawesi. It’s expected that the development of models for improving husband’s Information, AdvocacyandCommunication(IAC)of reproductive health could be a preventive effort in improving women’s reproductive health.

Role of Colour Doppler in High Risk Pregnancy

2021 ◽  
Vol 6 (2) ◽  
pp. 185-191
Author(s):  
Hiral Parekh ◽  
Sneha Chaudhari
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
High Risk Pregnancy ◽  
Colour Doppler ◽  
High Risk Factors ◽  
Risk Pregnancy ◽  
A Prospective Study

This was a prospective study conducted in pregnant patients with high risk factors who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Jamnagar during the period from May 2018 to September 2020. Background: High-risk pregnancies causes many adverse perinatal outcomes. Doppler ultrasound is a non-invasive technique to study the feto-maternal circulation to guide the clinical management. Objective: This study aims at evaluating the role of colour Doppler in high-risk pregnancies and their perinatal outcome. Materials and Methods: This was a prospective study carried out for 29 months in the Department of Radiology with antenatal women in the age group of 18-35 years with singleton pregnancy of gestational age of <28 weeks to >35 weeks having high-risk factors considered in study. The risk factors considered were pregnancy induced hypertension (PIH), gestational diabetes, anemia, oligohydramnios, polyhydramnios and IUGR. Doppler study of umbilical artery and fetal middle cerebral artery (MCA) arteries was done and amniotic fluid index (AFI) was measured. Parameters in the form of resistive index, pulsatility index, and systolic/diastolic ratio were taken. obstetric history was taken with regular interval follow up. Results: The study was carried out with 50 patients. High-risk pregnancy was more common in the age group of 21-25 years. The most common high-risk factor in pregnancy was oligohydramnios which accounted for 30% of cases. Out of 50 high-risk pregnancies, 5 (10 %) of cases resulted in intrauterine growth restriction (IUGR). Out of 50 high-risk cases, in 36 cases, umbilical artery findings were abnormal. 3 patients had intrauterine death (IUD) and 27 patients had poor perinatal outcome. Umbilical artery abnormality showed significant sensitivity and negative predictive value for adverse (poor + IUD) perinatal. Correlation was seen between high risk pregnancy and need of emergency caesarean section and induction and associated adverse perinatal outcome. Conclusion: Combination of different arterial waveform study enhance the diagnostic accuracy in identifying those intrauterine growth restricted foetuses that were at risk. Keywords: Colour Doppler, high risk pregnancy, perinatal outcome.

Early detection of embryonic malformations by transvaginal and color Doppler sonography.

1994 ◽  
Vol 13 (5) ◽  
pp. 347-355 ◽  
Author(s):  
F M Bonilla-Musoles ◽  
F Raga ◽  
M J Ballester ◽  
V Serra
Keyword(s):  
Early Detection ◽  
Doppler Sonography ◽  
Color Doppler ◽  
Color Doppler Sonography
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