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Indian Journal of Mednodent and Allied Sciences
Year : 2014, Volume : 2, Issue : 2
First page : ( 138) Last page : ( 143)
Print ISSN : 2347-6192. Online ISSN : 2347-6206.
Article DOI : 10.5958/2347-6206.2014.00002.8

The Role of Umbilical Artery Doppler in Predicting the Fetal Out Come in Cases of Pregnancy Induced Hypertension

Syed Mohammed Ismail*Assistant Professor, Ramanappa M.V., Professor and Head, Reddy K. Janardhan, Assistant Professor, Aditya Y., Assistant Professor

Department of Radio-Diagnosis, Santhiram Medical College & General Hospital, NH-18, Nandyal, Kurnool District, Andhra Pradesh, India

*Corresponding author email id: drismail80@gmail.com

Online published on 11 November, 2014.

Abstract

Purpose

To determine and compare the diagnostic performance of Doppler sonography of fetal umbilical artery (UA) for prediction of adverse perinatal outcome in suspected intrauterine growth retardation (IUGR) and pre eclampsia.

Materials and Methods

100 women with singleton pregnancy between 26 to 30 weeks of gestation were studied in this prospective study over a period of one and half years with color Doppler. UA flow velocity form was studied. In UA systolic/diastolic (S/D) ratio, pulsatility index (PI) and Resistance index (RI) were studied. In UA absent diastolic flow or reversed diastolic flow is noted.

Results

Out of 50 clinically suspected pregnancy induced hypertension (PIH) cases, 31 (62%) cases show abnormal PI, 40 (80%) cases show abnormal RI values and 45 (90%) cases show abnormal S/D Ratio's. Sensitivity and specificity of the S/D ratio in predicting PIH are 90% and 88% respectively followed by positive and Negative predictive value (PPV & NPV) of 88% and 89% whereas sensitivity, Specificity, PPV and NPV of RI & PI are lower than S/D ratio. This shows that S/D ratio has more Sensitivity, Specificity and Predictive values. Sensitivity of PI value in predicting fetal outcome is 75%. 22% (11 out of 50 cases) cases show absent/reversal of end diastolic velocities, of these four are reversal of end diastolic velocity (RDEV). All four cases of REDV died before 32 weeks of gestation. Absent diastolic flow is seen in 7 cases, 4 cases died and three cases admitted in NICU with severe respiratory distress. Our study shows absent or reversal of end diastolic velocity is more sensitive in predicting adverse fetal outcome. There was no case of eclampsia or maternal death.

Conclusion

UA flow velocity waveforms abnormality is more predictive for preeclampsia and IUGR. Hence Doppler is a promising tools in prediction of PIH and IUGR

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Keywords

Umbilical artery, Intrauterine growth retardation (IUGR), Pre eclampsia, Resistance index, Pulsatility index, S/D ratio, Absent/reversal of end diastolic velocity.

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