Screening of High-Risk Pregnancies by First and Second Trimester Uterine Artery Doppler for Improving Sensitivity in Prediction of Adverse Pregnancy Outcome
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 1961-1966
AbstractBackground: To determine the clinical value of first trimester and second-trimester
uterine artery Doppler indices in the prediction of adverse pregnancy outcome
(preeclampsia, IUGR, unexplained stillbirths).
Materials &Methods:This was a prospective study in which uterine artery Doppler was
performed at 22-24 weeks of gestation 100 high-risk women attending antenatal OPD at
Dr psims & rf in the first trimester between 11 to 13 weeks6days POG for early
pregnancy scan and uterine artery Doppler, followed with second-trimester uterine
artery doppler at the time of anomaly scan 18 to 20weeks from June 2019 to June 2020.
Results: Among the high-risk women in the present study the risk factors are chronic
hypertension (40%), precious pregnancy (10%), overt DM (12%), previous history of
preeclampsia (15%),RPL(10%),SLE (7%), twins (3%), oligohydramnios (3%).
Abnormal uterine artery Doppler indices had the highest sensitivity (100.0%) for
predicting preeclampsia in the mother and the lowest sensitivity (51.4%) for predicting
preterm. For predicting pre-eclampsia, IUGR, neonatal mortality, preterm the
sensitivity of RI was 100%,85.7%,83.3%,51.4% respectively, and the specificity was
92.3%,100%,95.8%,100% respectively. Overall, 35 (35.0%) women had a preterm
delivery, 16 (36%) had a cesarean delivery, and 19 (61%) had a spontaneous vaginal
delivery. Among the preterms, 18(51.4%) died due to prematurity and its associated
complications. The positive predictive value of abnormal uterine artery Doppler was
highest for preeclampsia (36.84%) among all adverse pregnancy outcomes assessed.
Conclusion: Uterine artery Doppler ultrasonography at 22-24 weeks of gestation is a
significant predictor of at least one adverse pregnancy outcome, with the highest
prediction for preeclampsia.
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