Evaluation of Efficacy and Usefulness of Doppler in Patients with Pregnancy Induced Hypertension

Efficacy and Usefulness of Doppler in Pregnancy Induced Hypertension

Abstract

Background: Hypertensive disorders of pregnancy are one of the commonest complications of pregnancy. Pregnancy induced hypertension (PIH) and small for gestational age (SGA) babies are pathological conditions strongly related to development and function of utero-placental and feto-placental circulations. The present study was conducted to evaluate the efficacy and usefulness of this new technology in patients with PIH and to evaluate the ability to predict the perinatal outcome.Subjects and Methods: The study group comprised of 30 pregnant patients between 28 to 36 weeks of pregnancy clinically diagnosed as PIH. Control group comprised of 30 patients with 28 to 36 weeks with no clinically detectable hypertension. Ultrasound examination and Doppler study was done. Colour Doppler and spectral Doppler were done in the same sitting. The Umbilical artery reflecting the foetoplacental circulation, the uterine artery reflecting the uteroplacental circulation and foetal middle cerebral artery reflecting foetal responses and adaptation to changes in the intrauterine growth retardation were studied. The wave form of uterine artery, umbilical artery and fetal middle cerebral artery was assessed with PHILIPS Envisor Doppler machine.Results:Normal S/D ratio was seen 56.7% (no=17), who had no REDV and no AEDV. They had 6.6% (no=2) still births, 6.6% (no=2) low birth weight babies and 43.3% (no= 13) had normal birth weight babies. In study group (PIH) of 30 patients, normal PI was seen in 36.7% patients and increased PI was seen in 63.3% patients. Of the patients with increased PI, 23.3% patients showed still-births, 23.3% patients had low birth babies.Conclusion: Doppler velocimetry of the feto-placental and utero-placental circulation has great potential in helping the managing obstetrician to identify the PIH patients with fetus at serious risk, which warrants urgent delivery by active intervention. It is helpful in distinguishing the serious patients from those where the approach can be a bit more conservative.