Mozibur Rahman Laskar 1 , Jyoti Prasad Deori 2
OBJECTIVES To evaluate the diagnostic value of various waveform of Doppler ultrasound of three vessels (uterine artery, middle cerebral artery and umbilical artery) in high-risk pregnancies in compare to normal pregnancy related to perinatal outcome. MATERIALS AND METHODS 200 singleton pregnancies beyond 28 weeks of gestation were studied out of which 100 were normal and 100 were high-risk pregnancies with PIH and clinical suspicion of IUGR. Doppler examination was done after recording history, clinical ex and USG. RESULTS The PI, RI and S/D of Umbilical artery and Uterine artery were significantly higher in study group as compared to control group and the PI, RI and S/D of middle cerebral artery were significantly lower in study group as compared to control group. 70% of foetuses in study group had at least one adverse outcome in study group in contrast to only 10% of control group had adverse outcome. Doppler study of UA and UmbA together had a better sensitivity than individual vessel. The MCA/UmbA PI ratio of study group showed more foetuses to redistribute their cardiac output than the abnormal MCA PI or UmbA PI. The cerebroumbilical ratio provided a better predictor of high-risk pregnancies and adverse perinatal outcome than either MCA or UmbA. CONCLUSION Hence, we conclude that Doppler studies of multiple vessels in the foetoplacental circulation can help in the monitoring of compromised foetus and can help in predicting neonatal morbidity. This may be helpful in determining the optimal time of delivery in complicated pregnancies. ABBREVIATIONS UA-Uterine artery, UmbA-Umbilical artery, MCA-Middle cerebral artery, RI-Resistive index, PI-Pulsatility index, S/DSystolic/Diastolic ratio, IUGR-Intrauterine growth restriction, IUFD-Intrauterine fetal demise, LSCS-Lower segment caesarean section, SVD-Spontaneous vaginal delivery, PIH- Pregnancy-induced hypertension.
