Role of uterine artery doppler at 12 to 16 weeks of gestation for the prediction of preeclampsia in women: an observational study

Abstract

Background: Preeclampsia is present in 2% -5% of pregnancies and is the major cause of perinatal and maternal morbidity and mortality. Doppler studies of the uterine artery in the first trimester is a major screening parameter for determining preeclampsia in women. Doppler is a non invasive and highly sensitive method to determine the fetoplacental circulation. The parameters assessed in Doppler are a high resistance index, persistent uterine artery notching and a high pulsatility index. Aims and objectives: To assess the role of uterine artery Doppler at 12 to 16 weeks of gestation for the prediction of preeclampsia. Material and methods: Hundred antenatal women of 12 to 16 weeks of singleton pregnancy were selected for the study. After an informed consent and detailed examination, the women were subjected to transvaginal ultrasound. Doppler assessment of uterine circulation and the various uterine artery indices were measured. The women were further followed up clinically for development of preeclampsia. Results: Out of 100 women, 31 patients developed preeclampsia. In our study 37% of the women had Bilateral uterine artery notching, mean RI was 0.5612, PI was 0.9104 at 12-16 weeks.Our study showed a statistically significant association between uterine artery diastolic notching, raised RI, PI and the development of preeclampsia as compared to non preeclamptic women. In our study, uterine artery notching at 12-16 weeks gestation has a sensitivity of 65.30%, specificity of 84.60%, PPV of 54.60% and NPV of 70.50%. When notch and RI >0.65 were taken together, the sensitivity changed to 82.60%, specificity to 85.40%, PPV to 37.60% and NPV to 98.40%. Conclusion:The uterine artery notching, high Resistance Index and Pulsatility Index in uterine artery Doppler waveform at 12-16 weeks has shown as best screening test for early prediction of preeclampsia.