Role of Uterine Artery Doppler Ultrasound in Predicting Pre-Eclampsia in High-Risk Women

Abstract

Background and objectivePre-eclampsia (PE) is a major cause of maternal morbidity and mortality. The utility of Doppler ultrasonography (U/S) in predicting PE has not been extensively explored. This study aimed to determine the role of Doppler U/S in predicting PE among high-risk women. MethodologyThis was a retrospective observational study conducted at the Department of Obstetrics and Gynecology of Abbasi Shaheed Hospital in Karachi, over a period of one year, from January 2019 till December 2019. A total of 325 women were initially screened for risk factors for PE. Among them, 75 women were eventually found to have risk factors for PE and hence included in the study. Uterine artery Doppler U/S was performed to evaluate uterine artery's flow velocity waveforms. They were then used to calculate the presence of diastolic notch and resistance index (RI). At each antenatal visit, the risk factors for PE such as BP, proteinuria, and signs and symptoms were noted. Women were labeled to have PE if they developed hypertension (BP >140/90) after 20 weeks of gestation in combination with proteinuria. ResultsTwenty women (28%) had a normal Doppler flow of the uterine arteries. In 54 (72%) women, a unilateral/bilateral RI >0.58 was observed, and 29 women (38.7%) had a bilateral Rl >0.58. Notching of the uterine artery was also observed in 42 (26.7%, unilateral/bilateral) and in 22 (29.3%) bilaterally. Among the 75 women, BP of 140/90 mmHg along with proteinuria was observed in 56 (76.7%) cases, which were hence diagnosed as PE. Based on the cutoff of Rl and notching of the uterine artery, the overall sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of Doppler U/S in predicting PE were 71.4%, 26.3%, 23.8%, and 74.1%, respectively. As far as individual Doppler U/S indices were concerned, RI >0.58 (unilateral/bilateral) was found to be most sensitive (71%), while the presence of uterine artery notch (unilateral/bilateral) was most specific in predicting PE. ConclusionAbnormal Doppler U/S has good overall sensitivity in predicting PE. Among individual Doppler indices, notching of uterine arteries had a better specificity compared to high RI.

Two-Dimensional Ultrasound and Triplane Tissue Doppler Ultrasound of Patients with Severe Preeclampsia

“…The E / e value of the Norm group was higher than that of the Ctrl group ( P < 0.05). These results suggested that the left ventricular systolic function of women during normal pregnancy had no significant change compared with nonpregnant women of reproductive age, which was different from the results of Shahid et al [ 19 ]. The gestational age of the included pregnant women was relatively small, and the left ventricular systolic function was in a compensated phase, so there was no significant difference compared with nonpregnant women of reproductive age.…”

Doppler de arterias uterinas para tamizaje y prevención de preeclampsia

“…Otro estudio indica que los índices Doppler individuales fueron los más sensibles con un 71% mientras que la presencia de una muesca en la arteria uterina (unilateral/bilateral) fue la más específica para predicción de PE, siendo la sensibilidad más baja la del IR bilateral con un 41% (63).…”

Considering the Effects and Maternofoetal Implications of Vascular Disorders and the Umbilical Cord

“…However, other studies have reported increased wall and tunica media thickness and an increase in the wall-luminal ratio [53]; therefore, more studies analysing these structural changes are needed. The utility of Doppler ultrasonography in predicting pre-eclampsia has not been extensively studied [75]. However, some studies show that abnormal Doppler ultrasonography has good overall sensitivity in predicting pre-eclampsia [75].…”

“…The utility of Doppler ultrasonography in predicting pre-eclampsia has not been extensively studied [75]. However, some studies show that abnormal Doppler ultrasonography has good overall sensitivity in predicting pre-eclampsia [75]. Some studies have also found relationships of preeclampsia with hypercoiling, marginal and paramarginal insertion, and SUA [73].…”