Study on role of obstetrical Doppler in pregnancies with hypertensive disorders of pregnancy

Lalthantluanga, Chhakchhuak; Devi, Ningthoukhongjam Romita; Singh, Ningombam Jitendra; Shugeta, Ningthoukhongjam D; Khuman, Victor; Keishing, Shangchungla

doi:10.4103/0972-4958.163195

J Med Soc

2015

DOI: 10.4103/0972-4958.163195

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Study on role of obstetrical Doppler in pregnancies with hypertensive disorders of pregnancy

Chhakchhuak Lalthantluanga

Ningthoukhongjam Romita Devi

Ningombam Jitendra Singh

et al.

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2024

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Prevalence and Factors Associated With Abnormal Cerebroplacental Ratio Among Women With Hypertensive Disorders of Pregnancy at a Tertiary Referral Hospital in Southwestern Uganda

Ibrahim,

Tornes,

Kayondo

et al. 2024

Journal of Pregnancy

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Background: Hypertensive disorders of pregnancy (HDP) are associated with placental insufficiency and adverse perinatal outcomes—over half (58.9%) of women with HDP at Mbarara Regional Referral Hospital (MRRH) have adverse perinatal outcomes. The cerebroplacental ratio (CPR) is an important predictor and prevents approximately 30% of these adverse perinatal outcomes. We determined the prevalence and factors associated with abnormal CPR among women with HDP at MRRH.Methods: We conducted a cross‐sectional study from December 2022 to May 2023 at the high‐risk obstetrics unit of MRRH. We consecutively enrolled all women with hypertensive disorders and gestational ages ≥ 26 weeks and performed obstetric Doppler studies to document the pulsatility index (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) and then calculated the CPR as a ratio of the MCA‐PI and UA‐PI. The prevalence of women with an abnormal CPR ≤ 1.0 was expressed as a percentage. We used robust modified Poisson regression analysis to determine the factors associated with abnormal CPR.Results: We enrolled 128 women with hypertensive disorders in pregnancy, with a mean age of 28.8 ± 6.3 years. Of these, 67 (52.3%) had abnormal CPR. The factors associated with abnormal CPR were severe pre‐eclampsia (adjusted prevalence ratio (aPR): 5.0, 95% CI: 1.28, 29.14) and eclampsia (aPR: 5.27, 95% CI: 1.11, 34.27).Conclusion: On average, half of the women with hypertensive disorders have abnormal CPR. Women with severe pre‐eclampsia or eclampsia are more likely to have abnormal CPR. Obstetric Doppler studies with CPR may be warranted for all pregnant women with severe pre‐eclampsia and eclampsia. We recommend further research to assess perinatal outcomes among those with and without abnormal CPR to profile women with HDP at increased risk of adverse perinatal outcomes.

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Prevalence and Factors Associated With Abnormal Cerebroplacental Ratio Among Women With Hypertensive Disorders of Pregnancy at a Tertiary Referral Hospital in Southwestern Uganda

Ibrahim,

Tornes,

Kayondo

et al. 2024

Journal of Pregnancy

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Color Doppler Evaluation of Fetomaternal Circulation in Patients with Pregnancy-induced Hypertension and its Value in Predicting Perinatal Outcome

Malhan,

Gupta,

Gupta

et al. 2024

Journal of Nature and Science of Medicine

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Context and Aim: The purpose of antenatal ultrasonography (USG) is to identify women at risk of complications due to various medical conditions such as pregnancy-induced hypertension (PIH) and preeclampsia. Our aim was to describe the practical application of Doppler indices of the uterine, umbilical, and fetal middle cerebral artery (MCA) in patients with PIH by comparing them with perinatal outcome. Materials and Method: A prospective longitudinal study of 50 pregnant women with a clinical diagnosis of PIH referred for USG and color Doppler and followed for any adverse perinatal outcome till 7 days after delivery was done. Patients were examined using the convex probe of 1–5 MHz frequency on the IU22 (Philips) machine. Results: In this study, 46% of patients were in the age group of 26–30 years and 64% were multiparous. Out of 50 patients, 43 were live births and 7 stillbirths. Out of live births, 35 required neonatal intensive care unit admission and five had neonatal mortality. Umbilical artery Doppler indices were altered in 42, uterine artery in 26, and fetal MCA in nine patients. Absent and reversed end-diastolic flow in the umbilical artery, the persistence of diastolic notch in the uterine artery, and the brain-sparing effect in fetal MCA represented the most ominous signs. Doppler indices were abnormal in more than one artery in stillbirths and neonatal deaths. Conclusion: The knowledge of the uterine, umbilical, and fetal cerebral artery waveforms helps to assess compromised uteroplacental and fetoplacental circulation in patients with PIH at the earliest. Hence, the detection of altered indices should be an alerting signal for intensive fetal monitoring and prompt intervention.

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Study on role of obstetrical Doppler in pregnancies with hypertensive disorders of pregnancy

Cited by 2 publications

References 0 publications

Prevalence and Factors Associated With Abnormal Cerebroplacental Ratio Among Women With Hypertensive Disorders of Pregnancy at a Tertiary Referral Hospital in Southwestern Uganda

Prevalence and Factors Associated With Abnormal Cerebroplacental Ratio Among Women With Hypertensive Disorders of Pregnancy at a Tertiary Referral Hospital in Southwestern Uganda

Color Doppler Evaluation of Fetomaternal Circulation in Patients with Pregnancy-induced Hypertension and its Value in Predicting Perinatal Outcome

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