Which is superior, Doppler velocimetry or non-stress test or both in predicting the perinatal outcome of high-risk pregnancies

Abstract

Background:The desire of all women considering motherhood is to culminate a healthy infant, whose physical and psychological potential might be greatest. Antepartum fetal surveillance is the corner stone of management aimed at reducing perinatal mortality and morbidity. Objectives: To analyze which is superior, Doppler velocimetry or Non-Stress Test or both, and by comparing the prediction of perinatal outcome in high-risk pregnancies like anemia, hypertensive disorders, IUGR, GDM, oligohydramnios, polyhydramnios. Methods: The study was done on a total of 100 pregnant women with high risk factors in the III trimester after 34 weeks till term, in the department of Obstetrics and Gynaecology. Complete history taking and general physical and systematic examination and investigations were done for all the patients. They were followed up till delivery and the outcome will be studied in detail. NST was repeated bi-Weekly. Doppler was performed once in 15 days or more frequently based on findings. Results: Majority of the patients belongs to age group 21-24 (38%) followed by age groups 15-20 (37%) and 25-29(19%).6% were aged between 30-35 years. Primi Gravidae with 58% and 42% were multi Gravidae. Majority of cases were between 38-39 wks. (44%). 33% between 36-37 Wks.12% between 34-35 Wks.11% are around 40 Wks. 41% are in Group A which is DOPPLER Normal and NST reactive. 25% are in Group B which is DOPPLER Normal and NST Non-Reactive. 23% are in Group C which is DOPPLER Abnormal and NST reactive. 11% are in Group D which is DOPPLER Abnormal and NST nonreactive. Conclusion:No single test result should be considered for decision making in case of high-risk pregnancy because each test reflects different aspects of maternal and fetal pathophysiology. It is advisable to repeat the test and combine with other modes of fetal surveillance before decision making to improve the perinatal outcome and for better prediction of adverse events.