Key result
Unilaterally increased uterine artery pulsatility index in the second trimester was significantly associated with adverse pregnancy outcomes (79.5% vs 18.55% with normal Doppler, p<0.01).
Why the study?
Does unilaterally increased uterine artery pulsatility index predict adverse pregnancy outcomes in pregnant women at 18-20 weeks gestation?
Observational (n=343)
No
Does unilaterally increased uterine artery pulsatility index predict adverse pregnancy outcomes in pregnant women at 18-20 weeks gestation?
Absolute Event Rate: 79.5% vs 18.55%
p-value: p=<0.01
Unilaterally increased uterine artery pulsatility index at 18-20 weeks of gestation is highly predictive of adverse maternal and perinatal outcomes, particularly preeclampsia and intrauterine growth restriction.
May aid high-risk pregnancy identification; leaves open whether unilateral uterine artery PI should guide management.
Adverse pregnancy outcome due to impaired placentation have been shown to demonstrate increased impedance in the spiral artery. The spiral arteries are firstly invaded by trophoblasts and which then becomes incorporated into the vessel wall and replaces the endothelium and muscular layer. This results in the conversion of the small spiral arteries into vessels of greater diameter with low resistance and high compliance, in absence of maternal vasomotor control. This study was a Prospective Observational study, carried out in the Department of Obstetrics and Gynaecology, in a tertiary care hospital. The study population consisted of pregnant women between 18 – 20 weeks of gestation with viable pregnancy. During pregnancy, 63(18.36%) women developed hypertensive disorders. Among these 63 patients, 37(58.73%) women had increased uterine artery pulsatility index in second trimester scan and 26(41.26%) had normal pulsatility index. The results were comparable for gestational hypertension with normal and unilaterally increased uterine artery PI and were not statistically significant.
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Adiga et al. (2018) conducted an observational in Pregnancy (n=343). Unilaterally increased uterine artery pulsatility index (PI > 1.5) vs. Normal uterine artery pulsatility index (PI < 1.5) was evaluated on Adverse pregnancy outcome (maternal or fetal/neonatal) (p=<0.01). Unilaterally increased uterine artery pulsatility index in the second trimester was significantly associated with adverse pregnancy outcomes (79.5% vs 18.55% with normal Doppler, p<0.01).
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