Efficacy of Umbilical Artery Doppler for the Prediction of Perinatal Outcome in Pre-Ecalmpsia

Abstract

Background: The most common medical problem encountered in pregnancy is hypertensive disorders and these remain a global public health challenge. Significant number of perinatal morbidities and mortalities are due to pre eclampsia mostly in developing countries. Doppler flow studies of the umbilical artery are non-invasive method of fetal surveillance in high risk pregnancies like preeclampsia. Adverse perinatal outcome is associated with abnormal umbilical artery flow. This study was designed to determine the efficacy of umbilical artery Doppler for the prediction of perinatal outcome in preeclampsia. Aim: To assess the frequency of perinatal outcome in preeclampsia patients with abnormal umbilical artery Doppler blood flow. Methodology: This Descriptive cross sectional study was held at Department of Obstetrics & Gynecology Unit III, Lady Willingdon Hospital/KEMU, Lahore for a period of six months from 1.1.2016 to 30.6.2016. After approval from ethical committee of the hospital, Cases of preeclampsia fulfilling the inclusion criteria were recruited for the study from labour ward. Umbilical artery Doppler flow study was carried out and the patients having abnormal umbilical artery Doppler flow (PI>1.2) were followed for perinatal outcome. Outcome variable like low Apgar score, Low birth weight, preterm delivery, early neonatal death and NICU admission were labeled as per operational definition. Results: According to the results reported to us the mean age of the patients was 26.85+3.89 years. Whereas, the mean gestational age was 33.02+1.59 at the time of presentation. The minimum value of abnormal pulsatility index of umbilical artery was found to be 1.21 and it had maximum value of 4.52. Mean pulsatility index was 2.07+0.79. Regarding perinatal outcome, in 72.7% (218) of the neonates, there was at least one adverse outcome. Majority of neonates, 216(72%) had birth weight <2.5Kg. 142 neonates (47.3%) out of 300 were delivered at less than 34 weeks. Poor Apgar score of <7 at 5 minutes was seen in 27 neonates (9%) and 157 (52.3%) neonates were admitted to NICU. Conclusions: Raised umbilical artery Doppler indices in pre-eclamptic patients are associated with poor perinatal outcome like low birth weight babies, NICU admission and preterm delivery.