UTERINE ARTERY DOPPLER IN SECOND TRIMESTER AS A PREDICTOR OF PRE-ECLAMPSIA AND FETAL GROWTH RESTRICTION

Dr. G. Naga Sudha Lakshmi; Dr. K. Vandana; Dr K.Sri Tanaya

Volume : IX, Issue : III, March - 2019

UTERINE ARTERY DOPPLER IN SECOND TRIMESTER AS A PREDICTOR OF PRE-ECLAMPSIA AND FETAL GROWTH RESTRICTION

Dr. G. Naga Sudha Lakshmi, Dr. K. Vandana, Dr K. Sri Tanaya

Abstract :

INTRODUCTION : Pre–eclampsia and fetal growth restriction are major causes of Perinatal morbidity and mortality. Several studies have shown that a generalized endothelial dysfunction is associated with these complications. Clinical trials have shown that pregnant women who demonstrate high resistance in utero– placental blood flow are at higher risk for pre–eclampsia and IUGR. OBJECTIVE : Uterine artery Doppler study both in the second and first trimester can predict pregnancies at increased risk of the complications of impaired placentation. The aim of the present study was to find the significance of uterine artery Doppler study in the prediction of pre–eclampsia and IUGR in second trimester . MATERIALS AND METHODS: This was a prospective cohort study done in the Department of Obstetrics and Gynaecology , Alluri Sitarama Raju Academy of Medical Sciences, Eluru from December, 2016 to September, 2018. A random sample of 100 women with singleton pregnancy between 20– 24 weeks were selected and subjected to uterine artery Doppler study. These women were followed up till their delivery and the details of pregnancy events, labour and delivery and neonatal outcome were noted. RESULTS: The data was collected and results were analyzed . The uterine artery Doppler study for pre–eclampsia had sensitivity 87.5% , specificity 82.8%, positive predictive value 61.7% and negative predictive value 95.4%. The efficiency of uterine artery Doppler study for Intra Uterine Growth Restriction has got the sensitivity 81.2%, specificity 82.7%, positive predictive value 43.3% and negative predictive value 95.7%. CONCLUSION : Normal pregnancy is characterized by a decrease of the uterine artery RI and PI values and disappearance of diastolic notch after 20 weeks of gestation. Women with normal impedance to flow in the uterine arteries constitutes a group that have a low risk (negative predictive value for pre–eclampsia is 95.4% and for IUGR is 95.7%) of developing obstetric complications related to utero placental insufficiency. Abnormal uterine artery Doppler is a better predictor of pre–eclampsia (sensitivity 87.5%) than fetal growth restriction(sensitivity 81.2%).