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

2010 ◽  
Vol 2 (1) ◽  
pp. 31-35 ◽  
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.

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 Third trimester Doppler ultrasound as prediction of obstetric outcome in high-risk pregnancy, Gujarat, India

2017 ◽  
Vol 6 (8) ◽  
pp. 3518
Author(s):  
Runoo Ghosh ◽  
Hina Oza ◽  
Shikha Meel
Keyword(s):  
High Risk ◽  
Middle Cerebral Artery ◽  
Lower Limit ◽  
Perinatal Outcome ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Ductus Venosus ◽  
Third Trimester ◽  
Adverse Perinatal Outcome ◽  
Diastolic Velocity

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.

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

2008 ◽  
Vol 198 (3) ◽  
pp. 330.e1-330.e7 ◽  
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

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 Significance of obstetric Doppler studies in prediction of perinatal outcome in pregnancy induced hypertension

2017 ◽  
Vol 6 (6) ◽  
pp. 2354 ◽  
Author(s):  
Pradip R. Gaikwad ◽  
Manisha R. Gandhewar ◽  
Nity Rose ◽  
Vidyadhar Suryakar
Keyword(s):  
Diagnostic Accuracy ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Perinatal Outcome ◽  
Uterine Artery ◽  
Pregnancy Induced Hypertension ◽  
Doppler Studies ◽  
Uterine Artery Doppler ◽  
Adverse Perinatal Outcome ◽  
Induced Hypertension

Background: Pregnancy induced hypertension (PIH) is associated with adverse perinatal outcome. Multi vessel color Doppler studies are useful in these cases for timely intervention. The aim of present study was to know the significance of umbilical, middle cerebral and uterine artery Doppler studies in PIH and to analyse its role in predicting perinatal outcome.Methods: This was a prospective study of 106 singleton pregnancies in the third trimester with PIH. The results of last Doppler ultrasound within one week of delivery were used for analysis. Adverse perinatal outcome was studied in the form of emergency cesarean section for fetal distress, meconium stained amniotic fluid, Apgar at 5 min <7, NICU admission and perinatal mortality (stillbirths and neonatal death). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of various Doppler parameters were calculated after comparing with standard.Results: In the present study specificity and diagnostic accuracy of all Doppler ultrasound parameters was high in predicting adverse perinatal outcome. Cerebroplacental ratio showed highest specificity (98.55%), PPV (94.44%) and diagnostic accuracy (80.19%) in predicting adverse perinatal outcome and it is better than MCA PI and UA PI alone. Uterine artery Doppler evaluation also gives additional information in predicting adverse perinatal outcome.Conclusions: Amongst various Doppler parameters cerebroplacental index (MCA/UA PI) is best predictor of adverse perinatal outcome.

Third trimester uterine artery Doppler indices as predictors of preeclampsia and neonatal small for gestational age

2019 ◽  
Vol 33 (20) ◽  
pp. 3484-3489
Author(s):  
Sarah G. Običan ◽  
Linda Odibo ◽  
Methodius G. Tuuli ◽  
Alejandro Rodriguez ◽  
Anthony O. Odibo
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Uterine Artery ◽  
Third Trimester ◽  
Uterine Artery Doppler ◽  
Doppler Indices
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