Kitty Elizabeth Mammen1
BACKGROUND
One of the most common complications of pregnancy is preeclampsia,
characterized by abnormal placental development, leading to inadequate
uteroplacental blood flow. Doppler ultrasonography can pick up these
abnormalities; thus, it is a useful tool to assess fetal outcome. Objective is to
calculate the role of colour Doppler (umbilical and middle cerebral artery) in
predicting the perinatal outcome. We wanted to evaluate the application of
Doppler ultrasound in analysing the blood flow velocity waveform.
METHODS
This was a cross sectional study carried out between May 2010 - November 2012
in Obstetrics Department, Yenepoya Medical College, Karnataka, among 150
pregnant women with preeclampsia.
RESULTS
49.3 % of patients belonged to 25 - 30 years, 58.7 % were primigravida, and 73.3
% and 26.7 % had mild and severe preeclampsia respectively. Patients with
increased resistance umbilical artery Doppler - 63.8 % had babies < 2.5 Kg birth
weight, 60.9 % Apgar < 7 at 5 minutes of birth and 67.5 % neonatal intensive
care unit (NICU) admissions; absent end diastolic flow - all had birth weight < 2
Kg, 90 % Apgar < 7 at 5 minutes, 1 neonatal death and all required NICU
admissions; reversal end diastolic flow - 1 neonatal death, all had birth weight <
2.5 Kg, an Apgar < 7 at 5 minutes and required NICU admission. Patients with
abnormal Doppler in middle cerebral artery, 46.2 % were low birth weight and
had Apgar < 7 at 5 minutes, 50 % required NICU admissions, but no perinatal
mortality.
CONCLUSIONS
Doppler analysis helps in early detection of uteroplacental and fetoplacental
changes and to take decisions for early interventions, like administration of
steroids for fetal lung maturity and transferring preterm pregnancies to higher
centres for better NICU facilities. Umbilical artery Doppler findings are slightly
better predictors of adverse perinatal outcome than an abnormal middle cerebral
artery.
