Background: Hypertensive disorders of pregnancy are one of the major causes of maternal morbidity-mortality leading to 10-15% of maternal deaths especially in developing areas of the world. The Doppler examination makes it possible by providing a unique, non-invasive and safe method of studying blood flow characteristics in both the fetoplacental and uteroplacental circulations that is being used in clinical evaluation of high risk pregnancies. The aim was to study early detection of fetoplacental compromise in hypertensive disorder of pregnancy with Doppler indices and to know its role in predicting perinatal outcomes and interventional strategies in these patients.Methods: This prospective study was conducted on 100 subjects, 50 patients in study group with hypertensive disorders and 50 patients in control group with normotensive pregnancy. Doppler studies of umbilical and middle cerebral artery done and parameters recorded were systolic/diastolic ratio, pulsatility index and resistance index at 28-37 weeks of gestation. Perinatal outcomes of both groups compared, analyzed statistically. Multiple pregnancy, chronic hypertension, fetal congenital anomalies, systemic disease and those lost to follow up till delivery were excluded from study.Results: Statistically significant difference in the incidence of induction of labour (p=0.012) and caesarean delivery (p=0.049), preterm delivery (p=0.004), low birth weight (p=0.003), low apgar score (p=0.045) and NICU admission in the patients with abnormal umbilical artery doppler of hypertensive group were seen .66.66% and 100% perinatal mortality seen in absent end diastolic flow and reverse end diastolic flow of umbilical artery in hypertensive group respectively.Conclusions: Abnormal umbilical artery had highest sensitivity 76% and positive predictive value 84% in predicting adverse perinatal outcome and MCA Doppler having highest specificity 96% to exclude the false positive results of abnormal UA. The sequential study of both vessels useful in predicting interventional strategies and improving perinatal outcomes.

Background: Early detection of fetoplacental compromise with Umbilical Artery Doppler indices and to know the predictive value of each indices in predicting perinatal outcome and interventional strategies in these patients.Methods: The present prospective study was conducted on 200 women with hypertensive disorder of pregnancy. Umbilical artery doppler evaluation done in all the patients at (28-32) weeks, (33-36) weeks and (37-40) weeks of gestation and more frequently in those patients having deranged Doppler. Patients divided into two groups women with abnormal Umbilical artery indices (group B) and normal indices (group A). Perinatal outcome of both the groups were compared, analyzed statistically using Chi-square test. Multiple pregnancy, chronic hypertension, fetal congenital anomalies, systemic disease and those lost to follow up till delivery were excluded from study.Results: A total of 200 pregnant women with hypertensive disorder, 64% were primgravida. Abnormal umbilical artery indices seen in 36%. Adverse outcome was seen in 88.88% patients of group B. Statistically significantly higher rate of caeserian section, induction of labour, Preterm delivery, fetal growth restriction, NICU admission, NICU stay >48hrs were seen in group B. In all indices Umbilical artery PI had highest Sensitivity (84.21%), positive predictive value (88.88%) and accuracy (90%).Conclusions: Umbilical artery PI is the most reliable to predict adverse perinatal outcomes and help in appropriate timing of intervention to improve perinatal outcome.

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Background: Fibroid uterus or leiomyoma is a benign tumour composed mainly of unicellular smooth muscle cells with varying amounts of fibrous connective tissue. UF are associated with significant morbidity as it presents in form of abnormal uterine bleeding, anaemia, pelvic pain, subfertility, and obstetric complications and causes financial burden on the patient. Recent studies have shown the critical role that vitamin D plays in fibroid formation, with individual fibroids expressing lower levels of vitamin D receptors than adjacent healthy tissue, making vitamin D deficiency a crucial, yet preventable risk factor.Methods: This was cross-sectional observational study. It was conducted on 140 female patients aged (18 to 50 years) presenting to the OPD of department of obstetrics and gynecology at NDMC & Hindu Rao Hospital during July 2019 to June 2020. 70 women had uterine fibroids on ultrasound and treated as cases and rest healthy women without fibroids served as controls. All women were subjected to ultrasound examination of uterus followed by serum vitamin D3 levels.Results: The mean value of vitamin D levels in cases was 12.81±8.56 ng/ml and in controls it was 19.83±9.21 ng/ml with p value<0.0001. Thus, it was statistically significant lower in cases of fibroid uterus as compared to controls. Secondary incidental outcomes were found between vitamin D3 level and BMI as fibroids occur statistically significantly more often in patient having of BMI ≥25 kg/m2. Also, menorrhagia and dysmenorrhea were the major complaints in 62.5% of cases followed by lowers abdominal pain and dyspareunia.Conclusions: Our study reached significance in the inverse correlation between fibroids and vitamin D levels at the primary outcome level. Larger prospective longitudinal studies drawing on more number and eliminating confounding variables are needed.