Surekha Narayan Khandale1 , Aashima Mittar Sen Garg2 , Gaurav Mangal3 , Swati Patel4
BACKGROUND Foetal growth restriction is the second most common cause of low birth weight after prematurity. Hypertensive disorders are some of the most common medical complications and are associated with a substantial increase in maternal perinatal morbidity and mortality. Evidence suggests that these conditions generally manifest later in pregnancy, but their underlying pathophysiology is established early in pregnancy. This finding has sparked great interest in the search for tests to predict them early in pregnancy before these complications occur. METHODS The study was carried out on 200 pregnant women of 20 - 24 weeks gestation in the Department of Obstetrics and Gynaecology, Indira Gandhi Government Medical College, Nagpur, from September 2017 to October 2019. All three doppler indices were studied and these patients were followed up till delivery, and details of pregnancy events, labour and delivery, and neonatal outcome were noted. The abnormal pregnancy outcomes considered were preeclampsia and foetal growth restriction. RESULTS Uterine diastolic notch shows high sensitivity (77.76%), specificity (94.52%), positive predictive value (84%), and negative predictive value (92%) in the prediction of pre-eclampsia and it also has high sensitivity (73.68%), specificity (86.42%), positive predictive value (56.9%), and negative predictive value (93.33%) in the prediction of foetal growth restriction as compared to abnormal PI and RI. Hence, uterine diastolic notch is associated with maternal morbidity and increased adverse perinatal outcome. CONCLUSIONS Women with abnormal uterine artery Doppler (at 20-24 weeks of gestation), are recommended intensive antenatal surveillance, adequate rest, nutritional supplements and institutional delivery as they may require intensive care at the time of delivery and baby may also require neonatal intensive care.
