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American Journal of Clinical Medicine Research. 2024, 12(1), 1-12
DOI: 10.12691/AJCMR-12-1-1
Original Research

Second Trimester Uterine Artery Doppler Study as a Predictor of Preeclampsia and Intrauterine Growth Restriction

Chidiebere Vincent Ali1, Boniface N Ejikeme1, Eziaha E Ede1, Michael Okoh Orji2, Ayodele Adegbite Olaleye1, , John C Irechukwu1, Nwabunike Ekene Okeke1, Chidi Ikenna Ebere1 and Emmanuel Onyekelu1

1Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki; Nigeria

2Department of Radiology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki; Nigeria

Pub. Date: March 10, 2024
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Chidiebere Vincent Ali, Boniface N Ejikeme, Eziaha E Ede, Michael Okoh Orji, Ayodele Adegbite Olaleye, John C Irechukwu, Nwabunike Ekene Okeke, Chidi Ikenna Ebere and Emmanuel Onyekelu. Second Trimester Uterine Artery Doppler Study as a Predictor of Preeclampsia and Intrauterine Growth Restriction. American Journal of Clinical Medicine Research. 2024; 12(1):1-12. doi: 10.12691/AJCMR-12-1-1

Abstract

Background: Impaired placentation with its associated increased impedance to blood flow in the uterine arteries is associated with complications in pregnancy such as pre-eclampsia and intra-uterine growth restriction (IUGR) among others. These complications are identified causes of maternal/perinatal morbidity and mortality. The uterine artery Doppler has potentials for screening for these pathological processes that are associated with impaired placentation. Objective: This study was designed to evaluate the predictive value of Doppler investigations of the uterine circulation in the second trimester (20-24 weeks of gestation) with regard to the development of some pregnancy complications such as pre-eclampsia and IUGR. Methods: This was a prospective longitudinal cross-sectional study of 354 low-risk women attending antenatal care at Alex Ekwueme Federal University Teaching Hospital Abakaliki. The study population was subjected to uterine artery Doppler study at 20-24 weeks gestation. The mean uterine artery Doppler indices such as pulsatitity index (PI), resistance index (RI) and presence of early diastolic notch (EDN) were obtained, and the outcomes of pre-eclampsia and intra-uterine growth restriction (IUGR) were studied. Data analysis was done using statistical package for social science (IBMSPSS) software (version 21, Chicago II, USA) at a statistical significance level of p < 0.05. Results: Out of the 354 women, 21(5.9%) developed pre-eclampsia and 27 (7.6% developed intra-uterine growth restriction. For pre-eclampsia, the resistance index showed a sensitivity of 66.7%, specificity of 91.9%, positive predictive value (PPV) of 34.2% and negative predictive value (NPV) of 97.8%; its pulsatility index showed a sensitivity of 71.4%, specificity of 95.5%, PPV of 50.0% and NPV of 98.2%; while for early diastolic notch had sensitivity of 66.7%, specificity of 94.3%, PPV of 42.4% and NPV of 97.8%. For intra-uterine growth restriction, resistance index showed a sensitivity of 59.3%, specificity of 92.4%, PPV of 39.0% and NPV of 96.5%; pulsatility index showed a sensitivity of 77.8%, specificity of 97.3%, PPV of 70.0% and NPV of 98.2%; while early diastolic notch had a sensitivity of 85.2%, specificity of 96.9%, PPV of 69.7% and NPV of 98.8%. Conclusion: The high negative predictive values indicated that women with normal Doppler velocimetry were unlikely to develop pre-eclampsia or intra-uterine growth restriction. Uterine artery Doppler, being non-invasive, can be included during routine sonography to identify patients at risk of developing pre-eclampsia or intra-uterine growth restriction. Early screening for pre-eclampsia and intra-uterine growth restriction will help in individualized antenatal surveillance and initiation of prophylactic therapy, and will help to reduce the adverse maternal and foetal complications of pre-eclampsia and intra-uterine growth restriction.

Keywords

early diastolic notching, intra-uterine growth restriction, pre-eclampsia, pulsatility index, resistance index, uterine artery Doppler velocimetry

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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