ABSTRACT
OBJECTIVE: To evaluate the association between uterine artery Doppler measurements and maternal complications among women with severe pre-eclampsia. METHODS: As part of a cross-sectional study, women with a single intrauterine pregnancy of more than 28 weeks and a diagnosis of severe pre-eclampsia were enrolled at a unit in Cairo, Egypt, between December 2012 and September 2014. Uterine artery Doppler was evaluated and maternal complications were recorded. RESULTS: Among the 100 participants, 76 (76%) experienced maternal complications. There were significant differences in resistance index (RI) and pulsatility index (PI) between women who experienced no complications and those who had accidental hemorrhage, HELLP syndrome, and acute pulmonary edema (P<0.001 for all), and postpartum hemorrhage (P=0.004 and P<0.001, respectively). There was no significant difference in RI for women with postpartum fits (P=0.360). There was a statistically significant difference regarding RI (P<0.001) and PI (P=0.005) between cases presenting with complications and those without. There was a significant negative correlation between PI and gestational age (r=-0.988; P<0.001) and between RI and gestational age (r=-0. 854; P<0.001), but no significant correlation between PI or RI and age, systolic blood pressure, or diastolic blood pressure. CONCLUSION: Increased uterine artery resistance in the third trimester of pregnancy could be used to predict postpartum maternal complications.
Subject(s)
Pre-Eclampsia/physiopathology , Pregnancy Complications/epidemiology , Ultrasonography, Doppler/methods , Uterine Artery/diagnostic imaging , Adult , Cross-Sectional Studies , Egypt , Female , HELLP Syndrome/epidemiology , Humans , Postpartum Hemorrhage/epidemiology , Postpartum Period , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Trimester, Third , Pulmonary Edema/epidemiology , Severity of Illness Index , Vascular Resistance/physiology , Young AdultABSTRACT
OBJECTIVE: To determine the value of fetal Doppler indices named middle cerebral artery (MCA)-PI, umbilical artery (UA)-PI and MCA-PI/UA-PI ratio, and amniotic fluid volume assessment in pregnancies 280-294 d and their correlation with the mode of delivery and perinatal outcome. STUDY DESIGN: Prospective observational study conducted on 100 whose gestational age (GA) from 40 to 42 weeks. MCA and UA Doppler and MCA-PI/UA-PI ratio, amniotic fluid volume (AFV) were assessed. They were divided into two groups based on the presence or absence of adverse perinatal outcome. RESULTS: Women with adverse perinatal outcome showed lower MCA-PI (0.92 versus 1.29), MCA-PI:UA-PI ratio (1.04 versus 1.83), lower gestational age when assessed by ultrasound (37.82 versus 39.48 weeks), lower neonatal birth weight (2705 versus 3108 g), fetal biophysical profile (BPP) (4.55 versus 7.21) when compared to women with normal perinatal outcome. They also had higher cases with oligohydramnios (34 versus 5), and higher UA-PI (0.89 versus 0.72). CONCLUSION: Women with adverse neonatal outcome had higher UA-PI and lower MCA-PI, MCA-PI:UA-PI ratio, GA (by US), AFV, BPP, estimated fetal weight, neonatal birth weight when compared to those with normal perinatal outcome. Women with adverse neonatal outcome had a higher rate of cesarean section mostly due to fetal distress and induced VD due to oligohydraminos compared to the normal outcome group.
