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

Abstract

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.

Correlation between Doppler Indices as A Predictor of Neonatal Outcome in Normal and Preeclamptic Pregnant Women in The Third Trimester

“…This study revealed that, MCA/UA PI and MCA/UAT PI ratio was significantly decreased among preeclamptic than the control group. This agreed with Ghosh et al (21) who found that MCA PI/UA PI ratio was <1, which was statistically significant (p<0.05) in 25.5% and absent in 17.3% among cases of adverse perinatal outcome. Also Shahinaj et al (22) found high sensitivity of the MCA/UA PI ratio in predicting stillbirth (100%).…”

Fetal ductus venosus Doppler as a predictor of pregnancy outcome

“…Doppler ultrasound study for fetal circulations would be a useful addition to the obstetrician catalog of tests for antenatal fetal well-being and timely intervention that might be effective in reducing mortality and major morbidity in high-risk pregnancy. 3 increased pulsatility index for veins) to the first-trimester screening. 4 The aim of this study was to evaluate the value of ductus venosus pulstality index of veins in early pregnancy in prediction of adverse pregnancy outcomes.…”