Publication:

Role of Doppler indices in prediction of perinatal outcome in preeclampsia

Background Preeclampsia is a major cause of maternal and perinatal mortality and morbidity worldwide, particularly in developing countries. The objective of the study was to study Doppler indices in pregnancies with preeclampsia and to correlate Doppler indices with perinatal outcome.

Methods This was a prospective study conducted within a period of September 2012 to August 2014 where 100 singleton preeclampsia patients attending tertiary care hospital were recruited. These patients were followed by serial Doppler assessment and the result of the last Doppler examination within 10 days of delivery was considered in the subsequent correlation with perinatal outcomes. Perinatal outcome was studied under major and minor adverse outcome.

Results In this study out of total population 54% were primigravida patients. 43.75% caesarean sections done for fetal distress with abnormal Doppler. Bilateral uterine artery diastolic notch and umbilical artery S/D ratio have better sensitivity (72.55%) for prediction of minor adverse outcome while uterine artery diastolic notch has better sensitivity (86.67%) for major adverse outcome. Umbilical artery and middle cerebral artery RI have better specificity and positive predictive value  for prediction of both major and minor adverse outcome. Bilateral uterine artery notch and umbilical artery S/D ratio have better negative predictive value for prediction of both major and minor adverse outcome.

Conclusions In this study it is concluded that Doppler analysis helps not only earlier detection of uteroplacental and fetoplacental changes associated with the disease but also help to take decision for early intervention. Doppler technology has provided the best opportunity for repetitive non-invasive haemodynamic monitoring in pregnancy for fetal well-being evaluation and predicting perinatal outcome.