UTERINE ARTERY DOPPLER STUDY FOR PREDICTION OF ADVERSE OUTCOME IN HIGH RISK PREGNANCY

AIM: To detect abnormal waveforms in uterine artery in pregnancies at risk between 20 to 24 weeks of gestation and to measure Resistance index (RI) and systolic/diastolic ratio(S/D) of these waveforms in study population and to study correlation of Doppler data with adverse pregnancy outcome. METHODS: This is a prospective study included Doppler analysis of uterine artery waveforms in 107 normotensive women with singleton pregnancy between 20 to 24 weeks of period of gestation who were considered to be at increased risk of developing pregnancy complications. Women with Multiple gestation, with congenital anomaly of fetus, chronic hypertension, renal disease, cardiac disease, Diabetes Mellitus were excluded from the study. Bilateral uterine artery Doppler was done and Parameters studied were S/D ratio and RI in uterine artery. Early diastolic notch in uterine artery was watched for. The flow velocity waveforms considered abnormal if there was an early diastolic notch in uterine artery in either right or left uterine artery was watched for abnormal pregnancy outcomes considered are Gestational hypertension, Pre-eclampsia IUGR, Abruptio placentae, IUD and preterm deliveries. RESULTS: minimum women were aged 21-25 year with minimum of 18 years and maximum of 36 years, 28% were primigravidae while 72% were multigravidae mean gestational age of which scan was done was 22 wks 1 day (20-24) minimum gestational age at time of delivery was 28 wks of gestation 70% women were delivered vaginally and 30% LSCS. 7% women developed Gestational Hypertension, 5% developed Preeclampsia, 8% neonates with IUGR, 3% developed Placental Abruption while 4% had IUD and 8% had Preterm deliveries. CONCLUSION: Abnormal uterine artery Doppler studies in second trimester have been associated with subsequent adverse pregnancy out comes including Preeclampsia IUGR and perinatal mortality. Doppler velocimetry is a primary tool for fetomaternal surveillance in high risk pregnancies as the changes in uterine artery circulation strongly correlate with pregnancy outcome, it helps us to take timely action, to plan the treatment and also counsel the patient in their future pregnancies.