Publication:

The role of first trimester uterine artery pulsatility index as a predictor of hypertensive disorders of pregnancy in the department of obstetrics and gynaecology, Sawai Man Singh Medical College, Jaipur

Background This study was conducted to assess the relationship between mean uterine artery pulsatility index at 11+0 to 13+6 weeks and the development of hypertensive disorders of pregnancy.

Methods This prospective study was carried out on 320 pregnant women. In all subjects mean uterine artery PI was calculated at 11+0 to 13+6 weeks and association of value of uterine artery PI and development of hypertensive disorder of pregnancy were compared by receiver operative curve analysis.

Results The ROC curve analysis shows that at the cut-off value of 1.62, overall sensitivity, specificity, positive predictive value, and negative predictive value of PI for prediction of hypertensive disorder of pregnancy in our study was 82.1% (95% CI- 63.1-93.9%), 57.4% (95% CI- 51.5-63.2%), 15.7% (95% CI- 13.1-18.9%) and 97.1% (95% CI-93.7-98.7%) respectively. When we evaluate 11+0 to 13+6 weeks UtA PI value with hypertensive disorders of pregnancy and early-onset hypertensive disorders of pregnancy by AUC curve, we found that the area under curve was 0.73 (95% CI 0.64-0.81) and 0.78 (95% CI 0.69-0.86) respectively.

Conclusions Uterine artery pulsatility index at 11+0 to 13+6 weeks is significantly higher in women who develop hypertensive disorder in pregnancy. Our study also shows that 11±0 to13±6 weeks uterine artery pulsatility index was a more significant predictor of early onset pre-eclampsia. It is a simple, non-invasive, reliable test which can be performed as an adjunct to routine ultrasound examination to predict hypertensive disorders.