Prediction of preeclampsia by midtrimester uterine artery Doppler velocimetry in high-risk and low-risk women.

OBJECTIVE: To observe the role of uterine artery Doppler flow velocimetry at midtrimester in prediction of preeclampsia. METHOD: 179 women carrying <16 weeks of pregnancy, with singleton fetus and without any fetal anomaly were recruited and were divided in high-risk and low-risk group. Doppler velocimetry of uterine artery was done at 24-26 weeks. Any notch in uterine artery, unilateral or bilateral, or RI > 0.6, was considered abnormal. Women were followed up and development of preeclampsia noted. RESULT: Sensitivity and specificity of abnormal uterine artery Doppler study for prediction of preeclampsia were 73.33 and 86.48 % in high-risk and 57.14 and 95.83 % in low-risk group, respectively. Relative risk with 95 % confidence interval was 5.427 (2.272-12.958) in high-risk and 13.65 (5.669-32.865) in low-risk women. CONCLUSION: Doppler velocimetry of uterine artery at 24 weeks can be used as a reliable screening test for prediction of preeclampsia in both high-risk and low-risk women.

Ovarian multifoetal pregnancy.

A 24 years Muslim lady was admitted to SSKM Hospital with the complaint of pain lower abdomen, more on left side with ultrasonography diagnosis of alive foetuses in a twin pregnancy of 19-20 weeks of gestational age. On the very next day, foetal heart sound disappeared with complaint of no foetal movement. Doppler study and USG confirmed death of the foetuses. Laparotomy performed 3 weeks after foetal death revealed soft bulky uterus of about 10 weeks gestational age. Left fallopian tube was found highly stretched over the upper aspect of gestational mass and left overy could not be traced. Total hysterectomy with removal of the mass and left tube with preservation of right ovary and tube was carried out. On pathological examination, the uterus and the gestational mass were found empty and separated from the mass. There were two gestational sacs with two separate placentae, cords and foetuses of 20 weeks maturity. Microscopic examination showed infiltration of ovarian stroma by intermediate trophoblast indicating ovarian nidation.