Key result
Uterine artery Doppler screening for pre-eclampsia based on resistance index demonstrated a sensitivity of 66.6%, specificity of 89.3%, positive predictive value of 28.5%, and negative predictive value of 97.5%.
Why the study?
Does uterine artery Doppler screening predict the development of pre-eclampsia in pregnant women?
Cohort
No
Does uterine artery Doppler screening predict the development of pre-eclampsia in pregnant women?
Uterine artery Doppler screening showing increased impedance or an early diastolic notch after 24 weeks of pregnancy is associated with a higher risk of developing pre-eclampsia.
May aid ruling out pre-eclampsia; hypothesis-generating and requires prospective validation before clinical adoption.
BACKGROUND artery represents the major portion of the anterior division of the internal iliac artery during pregnancy. 1 second of pregnancy, uterine blood flow increases from 50 ml/min in the non-pregnant woman to over 700 mL/min. During pregnancy, the diastolic component of the uterine artery doppler wave form is thus transformed from one of low peak velocity and an early diastolic notch by 18-22 weeks. 2 The average increase in resistance index in the left and right artery and its association with an early diastolic notch is found in patients, when there is impaired placentation. If diastolic notch persists beyond 24 wks. of pregnancy, then this indicates a severe adverse outcome in both mother and defined by intra uterine growth restriction and foetal asphyxia that may be followed by pre-eclampsia and foetal death. 3 and Objectives- The aim of this study was to identify pre-eclampsia during present and subsequent pregnancies by of placental insufficiency by uterine artery Doppler. AND METHODS mothers were recruited from antenatal outpatient department of R. G. Kar. Medical College & Hospital. Both and hypertensive pregnant mothers were included in study. Pregnant mothers with multiple gestations, anomalies and preterm deliveries were excluded from the study. In this study, two-stage screening test of uterine was done by pulsed wave doppler, one at 14-18 wks. and the other at 26-28 wks. of gestation. In the wave of both arteries, an early diastolic notch was also carefully observed. Mothers were followed up to the delivery to observe -eclampsia. Sensitivity, specificity, positive predictive value & negative predictive value of pre-eclampsia were calculated to the resistance index. our study, 40% of pregnant mothers were primigravidas and 60% were multigravidas. The sensitivity, specificity, PPV and of pre-eclampsia are 66.6%, 89.3%, 28.5%, and 97.5% respectively. higher risk of developing pre-eclampsia is seen in pregnant women with an early diastolic notch after 24 wks. of pregnancy. is association between increased impedance to flow in the uterine arteries with increased risk for subsequent of pre-eclampsia.
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Sukharanjan Howlader (2018) conducted a cohort in Pre-eclampsia. Uterine artery Doppler screening vs. Normal uterine artery Doppler was evaluated on Pre-eclampsia. Uterine artery Doppler screening for pre-eclampsia based on resistance index demonstrated a sensitivity of 66.6%, specificity of 89.3%, positive predictive value of 28.5%, and negative predictive value of 97.5%.
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