The Relationship between Uterine Artery Doppler Index and Adverse Pregnancy Outcomes: A Prospective Cohort Study

Document Type : Original Article

Authors

1 General practitioner, Student Research Committee, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

2 M.Sc. of Counseling in midwifery, Vice Chancellor for Treatment, Sabzevar University of Medical Sciences, Sabzevar, Iran.

3 Assistant Professor, Department of Anesthesiologist, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

4 M.Sc. in Biostatistics, Department of Community Medicine, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran. PhD Candidate in Medical Education, Department of Medical Education, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

5 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

6 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran.

10.22038/ijogi.2024.76401.5926

Abstract

Introduction: Increased Doppler indices of uterine artery correlate with adverse pregnancy outcomes. The present study was conducted with aim to investigate the relationship between elevated resistance in the pulsatility index (PI) of the uterine artery at 18-20 weeks of pregnancy and adverse pregnancy outcomes.
Methods: In this prospective cohort study, colour Doppler ultrasonography was performed on 173 patients referred to the perinatology office at Sabzevar University of Medical Sciences during 18-20 weeks of pregnancy. The 95th percentile of the average uterine PI was recorded. After delivery, adverse pregnancy and childbirth outcomes were evaluated. Data were analysed using SPSS (version 26) and Fisher's exact test and Mann-Whitney U test.
Results: In terms of maternal and fetal outcomes, one case (2.3%) experienced intrauterine fetal death (IUFD), two (4.5%) had premature births, eight infants (18.2%) were hospitalized in the neonatal intensive care unit (NICU), and four (9.1%) had low birth weight (LBW). No cases of infant deaths or intrauterine growth restriction (IUGR) were reported. A significant relationship was found between mean PI exceeding 1.5 and high blood pressure during pregnancy (p=0.003). Additionally, significant relationship was found between an elevation in resistance beyond the 95th percentile of the PI and increased blood pressure (p=0.005) and premature delivery (p=0.04). However, no significant relationships were noted between mean and the 95th percentile of the PI and other maternal and fetal outcomes.
Conclusion: No cases of infant deaths and IUGR were reported. The elevated uterine artery PI is associated with increased risk of gestational hypertension and preterm delivery.

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Main Subjects

References

  1. Varun N, Singh N. Role of Doppler velocimetry of uterine artery in obstetrics: Review article. J Pregnancy Child Health 2017; 4:347-50.
  2. Kavitha G, Palakodeti N, Samalla S. Role of color doppler ultrasonography in high risk pregnancies: a retrospective study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2019; 8(12):4915-9.
  3. Meler E, Martínez J, Boada D, Mazarico E, Figueras F. Doppler studies of placental function. Placenta 2021; 108:91-6.
  4. Adekanmi AJ, Roberts A, Morhason-Bello IO, Adeyinka AO. Utilization of uterine and umbilical artery doppler in the second and third trimesters to predict adverse pregnancy outcomes: a Nigerian experience. Women's Health Reports 2022; 3(1):256-66.
  5. Tian Y, Yang X. A review of roles of uterine artery Doppler in pregnancy complications. Frontiers in medicine 2022; 9:813343.
  6. Moreta D, Vo S, Eslick GD, Benzie R. Re-evaluating the role of cerebroplacental ratio in predicting adverse perinatal outcome. European Journal of Obstetrics & Gynecology and Reproductive Biology 2019; 242:17-28.
  7. Dhar A, Kaul I. Value of PI of uterine artery at 23-24 weeks in the prediction of adverse pregnancy outcome. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2017; 6(12):5435-40.
  8. Allen RE, Morlando M, Thilaganathan B, Zamora J, Khan KS, Thangaratinam S, et al. Predictive accuracy of second‐trimester uterine artery Doppler indices for stillbirth: a systematic review and meta‐analysis. Ultrasound in Obstetrics & Gynecology 2016; 47(1):22-7.
  9. Patwa PA, Mishra GV, Singh RK, Manoj M, Dhande RP, Singh S, et al. Prediction of preeclampsia and adverse pregnancy outcome on the basis of uterine artery doppler. Journal of Datta Meghe Institute of Medical Sciences University 2022; 17(1):7-13.
  10. Abdel Wahid DH, Mahdy MS, Mowafy HE, Abdelsalam WA. Predicting Adverse Pregnancy Outcomes during the Late First Trimester and Early Second Trimester Using the Uterine Artery Doppler. The Egyptian Journal of Hospital Medicine 2021; 85(2):3810-5.
  11. Tay J, Masini G, McEniery CM, Giussani DA, Shaw CJ, Wilkinson IB, et al. Uterine and fetal placental Doppler indices are associated with maternal cardiovascular function. American journal of obstetrics and gynecology 2019; 220(1):96-e1.
  12. Stoenescu M, Serbanescu MS, Dijmarescu AL, Manolea MM, Novac L, Tudor A, et al. Doppler uterine artery ultrasound in the second trimester of pregnancy to predict adverse pregnancy outcomes. Current Health Sciences Journal 2021; 47(1):101.
  13. Tellapragada C, Eshwara VK, Bhat P, Acharya S, Kamath A, Bhat S, et al. Risk factors for preterm birth and low birth weight among pregnant Indian women: a hospital-based prospective study. Journal of Preventive Medicine and Public Health 2016; 49(3):165.
  14. Chehreh R, Karamolahi Z, Aevazi A, Borji M, Saffar A. Prevalence of preterm birth recurrence and related factors in Ilam. The Iranian Journal of Obstetrics, Gynecology and Infertility 2018; 21(10):20-9.
  15. Aljawadi HF, Ali EA, Kareem SH. Preterm Incidence with Analytical Assessment of Causes and Risk Factors of Mortality. Journal of Babol University of Medical Sciences 2020; 22(1):101-9.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 8
October 2024
Pages 21-30

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