Uterine Artery Doppler Velocimetry for the Prediction of Preeclampsia among High-risk Pregnancies in Low-resource Setting: Our Experience at Aminu Kano Teaching Hospital, Kano, Nigeria

ABSTRACT Several Doppler studies have demonstrated an association between increased impedance to flow in uterine arteries and subsequent development of preeclampsia. This study evaluated the usefulness of uterine artery Doppler velocimetry in the prediction of preeclampsia in high-risk pregnancies. The study was a prospective cohort study carried out on 138 pregnant women attending antenatal clinic in Aminu Kano Teaching Hospital, a tertiary center in Northern Nigeria. Assessment of uterine artery blood flow by Doppler ultrasound was carried out at 20 to 24 weeks of gestation. The test was considered abnormal when the mean resistance index (RI) in the uterine arteries was .0.58 with or without diastolic notch (DN). The women were then followed up to determine those who developed preeclampsia. The prevalence of preeclampsia in this study was found to be 12.3%. Twenty one of the patients (15.2%) had high uterine artery RI (. 0.58), while 117 (84.8%) had normal RI (<0.58). The prevalence of preeclampsia was significantly higher (p < 0.05) in the group with high RI than in the group with normal RI (57.1 compared with 4.2%). Nine of the patients (6.5%) had DN, while 129 (93.5%) had no DN. The prevalence of preeclampsia was also significantly higher (p < 0.05) in the group with DN than in the group with no DN (55 compared with 9.3%). Both the sensitivity (70.5%) and specificity (92.6%) of abnormal RI in the prediction of preeclampsia were found to be high. This study confirmed the efficacy of second trimester screening for preeclampsia in high-risk pregnancies using a combination of maternal characteristics and uterine artery Doppler. How to cite this article Yusuf M, Galadanci H, Ismail A, Aliyu LD, Danbatta AH. Uterine Artery Doppler Velocimetry for the Prediction of Preeclampsia among High-risk Pregnancies in Low-resource Setting: Our Experience at Aminu Kano Teaching Hospital, Kano, Nigeria. Donald School J Ultrasound Obstet Gynecol 2017;11(3):197-202.

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High burden of Carbapenem-resistant Enterobacteriaceae (CRE) fecal carriage at a teaching hospital: cost-effectiveness of screening in low-resource setting

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-017-0200-5 ◽

2017 ◽

Vol 6 (1) ◽

Cited By ~ 10

Author(s):

Abdul Rahman Zaidah ◽

Nurul Izzah Mohammad ◽

Siti Suraiya ◽

Azian Harun

Keyword(s):

Cost Effectiveness ◽

Teaching Hospital ◽

Hospital Cost ◽

High Burden ◽

Low Resource ◽

Carbapenem Resistant ◽

Fecal Carriage ◽

Resource Setting ◽

Low Resource Setting ◽

Carbapenem Resistant Enterobacteriaceae

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Factors associated with high-risk HPV positivity in a low-resource setting in sub-Saharan Africa

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2013.08.038 ◽

2014 ◽

Vol 210 (1) ◽

pp. 81.e1-81.e7 ◽

Cited By ~ 16

Author(s):

Sheona M. Mitchell ◽

Musa Sekikubo ◽

Christine Biryabarema ◽

Josaphat J.K. Byamugisha ◽

Malcolm Steinberg ◽

...

Keyword(s):

High Risk ◽

Sub Saharan Africa ◽

Factors Associated ◽

Low Resource ◽

Resource Setting ◽

Low Resource Setting ◽

Sub Saharan ◽

High Risk Hpv

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

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i10.38390 ◽

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.

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PREDICTION OF PREECLAMPSIA BY UTERINE ARTERY DOPPLER VELOCIMETRY BETWEEN 16-28 WEEKS

10.36106/gjra/3002070 ◽

2021 ◽

pp. 56-60

Author(s):

Ashraf M Ali ◽

Prameela Prameela ◽

Aseem Basha ◽

Sonal Garg

Keyword(s):

High Risk ◽

Predictive Value ◽

Uterine Artery ◽

Risk Group ◽

Indirect Evidence ◽

Low Risk ◽

Predictive Test ◽

Doppler Velocimetry ◽

Uterine Artery Doppler ◽

Doppler Study

Background: Preeclampsia is a multisystem disorder which affects about 2% of pregnancies and represents a major threat to mother and foetus when it emerges. In some women this condition sets in a subtle way and gradually such women develop severe degree of preeclampsia leading to dreadful complications. Uterine artery doppler velocimetry is a non-invasive method to examine the uteroplacental circulation that provides indirect evidence of blood ow and is proposed a predictive test for preeclampsia. This prospective observational study was performed to assess the usefulness of uterine artery Doppler in predicting preeclampsia. Methods: 50 high risk and 50 low risk singleton pregnancies between 16-28 weeks of gestational age with uterine artery doppler study were followed up till delivery or development of preeclampsia to determine maternal and fetal outcome. Results: Sensitivity and specicity of abnormal uterine artery doppler study for prediction of preeclampsia were 90 % and 70 % in high-risk and 42 % and 90 % in low-risk group, respectively. Positive predictive value and negative predictive value was 92 % and 63 % in high risk group and 42 % and 90 % in low risk group respectively. Conclusions: Mid trimester doppler velocimetry of uterine artery can be used as a reliable screening test for prediction of preeclampsia in both high-risk and low-risk women.

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Predicting Obstetric Vasculopathies through Study of Diastolic Notch and other Indices of Resistance to Blood Flow in Uterine Artery

International Journal of Infertility & Fetal Medicine ◽

10.5005/jp-journals-10016-1056 ◽

2013 ◽

Vol 4 (1) ◽

pp. 24-30

Author(s):

Pankaj Desai

Keyword(s):

Blood Flow ◽

High Risk ◽

Uterine Artery ◽

Screening Method ◽

Resistance Index ◽

Waveform Analysis ◽

Large Set ◽

Uterine Artery Doppler ◽

Recurrent Miscarriages ◽

Uterine Arteries

ABSTRACT Obstetric vasculopathies are a set of apparently heterogeneous and poorly understood conditions. Conditions like recurrent miscarriages due to fetal demise, pre-eclampsia, IUGR, recurrent still births and accidental hemorrhage all seem to have the same underlying etiopathology. They are grouped into one large set coined as ‘Obstetric Vasculopathies’. Resistance to blood flow in the uterine arteries can be important and effective method to predict obstetric vasculopathies (except recurrent miscarriages). Resistance to this blood flow can be measured by the presence (and subsequent disappearance) of diastolic notch as well as the standard color Doppler indices namely Pulsatility Index (PI), Resistance Index (RI) and Systolic: Diastolic (S: D) ratio. In normal pregnancy almost always at 12 to 14 weeks of duration, the uterine artery shows presence of a diastolic notch. In high-risk subjects, disappearance of diastolic notch at midtrimester in uterine artery Doppler waveform analysis if used alone may not be a good screening method for obstetric vasculopathies. However, the combination of a diastolic notch and an abnormal resistance index in both uterine arteries at 20 weeks gestation is more accurate indicator in predicting severe pregnancy complications. These subjects are almost eight times more likely to develop either: Clinically significant hypertension and/or deliver prior to 32 weeks and/or have a perinatal demise and/or have an Infant with a birth weight of less than 1500 gm. Bilateral or Unilateral: Studying bilateral uterine artery seems to be more accurate that unilateral artery for prediction of obstetric vasculopathies. Prediction in I-Trimester: Disappearance of uterine artery diastolic notch in combination with other parameters seems to be a good test for prediction of obstetric vasculopathies particularly PIH and IUGR in I-Trimester. The advantage of such an early allows an early instituting of preventive measures. Notch Depth Index (NDI): It is calculated as the depth of the diastolic notch divided by the maximal diastolic velocity. The NDI value in the second trimester is associated with the later onset of pre-eclampsia, and is clinically more useful in predicting pre-eclampsia than the two conventional indices. Abnormal maternal uterine artery Doppler in association with elevated maternal serum AFP, HCG, Inhibin A or decreased PAPP-A identifies a group of subjects at greater risk of IUGR and gestational hypertension with proteinuria. Lowdose aspirin administered as early as 14 to 16 weeks of gestation to pregnant subjects at high risk of pre-eclampsia with abnormal uterine Doppler findings may reduce or modify the course of severe pre-eclampsia and may help in prevention of IUGR. How to cite this article Desai P. Predicting Obstetric Vasculopathies through Study of Diastolic Notch and other Indices of Resistance to Blood Flow in Uterine Artery. Int J Infertility Fetal Med 2013;4(1):24-30.

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