Evaluation of Uterine artery indexes in Doppler sonography for predicting neonatal outcomes in preeclamptic pregnancies

Document Type : Original Article

Authors

1 Assistant Professor, Department of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Obstetrics and Gynecology, Women’s Health Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Associate Professor, Department of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Assistant Professor, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Resident of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Resident of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: Introduction: preeclampsia is associated with various maternal and neonatal outcomes such as intra-uterine growth retardation, preterm labor and increased risk of fetal mortality. It seems that increased uterine vascular resistance is associated with higher risk of preeclampsia progression. This study was performed with aim to investigate uterine artery indexes in Doppler sonography for predicting neonatal outcome in preeclamptic pregnancies.
Methods: this prospective study was conducted on 46 pre-eclampsia and 74 normal pregnant women referred to Emam Reza and Omalbanin hospitals in 2014. Trans-abdominal Doppler sonography was conducted between 26-36 weeks of pregnancy at supine position and Doppler signals of uterine artery indexes were evaluated and after delivery, neonatal complications were added to the form of evaluation. Data was analyzed by SPSS software (version 16) and T-student, Chi-square and Mann-Whitney tests. PResults: The highest sensitivity, specificity and positive predictive value for the mean Pulsatility index of uterine artery in women with preeclampsia in predicting of low birth weight infants were 51.7% and 90.9% and 93.7%, respectively. The highest sensitivity and positive predictive value of uterine artery resistance index in predicting of low birth weight infants were 62% and 94.7%, respectively. Also, mean uterine artery resistance index in prediction of all adverse pregnancy outcomes had high specificity.
Conclusion: Although uterine artery indexes in Doppler sonography has no high sensitivity to predict neonatal outcomes, but their abnormal range can predict low birth weight.

Keywords


  1. Shojaeian Z, Sadeghian Harat R, Negahban Z. Prediction value of hemoglobin and hematocrit concentration during second trimester in diagnosis of preeclampsia. Iran J Obstet Gynecol Infertil 2010; 12(4):14-21. (Persian).
  2. Komacki J, Skrzypczak J. The use of Doppler in the second half of pregnancy. Ginekol Pol 2015; 86(8):626-30.
  3. Anderson UD, Gram M, Åkerström B, Hansson SR. First trimester prediction of preeclampsia. Curr Hypertens Rep 2015; 17(9):1-8.
  4. Shahidifar S, Sharifnia H, Taghipoor B, Hekmat Afshar M, Motevalli R, Khalili Y, et al. Association between seasonal patterns and preeclampsia. Iran J Obstet Gynecol Infertil 2014; 17(125):8-14. (Persian).
  5. Jadli A, Sharma N, Damania K, Satoskar P, Bansal V, Ghosh K, et al. Promising prognostic markers of preeclampsia: new avenues in waiting. Thromb Res 2015; 136(2):189-95.
  6. Brunelli VB, Prefumo F. Quality of first trimester risk prediction models for pre-eclampsia: a systematic review. BJOG 2015; 122(7):904-14.
  7. Park F, Russo K, Williams P, Pelosi M, Puddephatt R, Walter M, et al. Prediction and prevention of early-onset pre-eclampsia: impact of aspirin after first-trimester screening. Ultrasound Obstet Gynecol 2015; 46(4):419-23.
  8. Tayyar A, Guerra L, Wright A, Wright D, Nicolaides KH. Uterine artery pulsatility index in the three trimesters of pregnancy: effects of maternal characteristics and medical history. Ultrasound Obstet Gynecol 2015; 45(6):689-97.
  9. Moon M, Odibo A. First-trimester screening for preeclampsia: impact of maternal parity on modeling and screening effectiveness. J Matern Fetal Neonatal Med 2015; 28(17):2028-33.
  10. Stubert J, Ullmann S, Bolz M, Külz T, Dieterich M, Richter DU, et al. Prediction of preeclampsia and induced delivery at< 34 weeks gestation by sFLT-1 and PIGF in patients with abnormal midtrimester uterine Doppler velocimetry: a prospective cohort analysis. BMC Preg Childbirth 2014; 14(1):292.
  11. Goetzinger KR, Tuuli MG, Cahill AG, Macones GA, Odibo AO. Development and validation of a risk factor scoring system for first-trimester prediction of preeclampsia. Am J Perinatol 2014; 31(12):1049-56.
  12. Doddamani GB, Doddamani UG. Prenatal outcome in pre-eclampsia: a prospective study. Sch J Appl Med Sci 2014; 2(1C):291-3.
  13. Talari H, Mesdaghinia E, Abedzadeh Kalahroudi M. Aspirin and preeclampsia prevention in patients with abnormal uterine artery blood flow. Iran Red Crescent Med J 2014; 16(8):e17175.
  14. Davoudi Y, Fard MM, Madarshahian F. Evaluation of the uterine artery resistance index by Doppler ultrasonography in pregnant women with chronic hypertension. J Birjand Univ Med Sci 2007; 14(2):9-15. (Persian).
  15. Cnossen JS, Morris RK, ter Riet G, Mol BW, van der Post JA, Coomarasamy A, et al. Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ 2008; 178(6):701-11.
  16. Bhatnagar L. Study of low birth weight neonates. Med J Arm Force India 2000; 56(4):293-5.
  17. Cifuentes J, Bronstein J, Phibbs CS, Phibbs RH, Schmitt SK, Carlo WA. Mortality in low birth weight infants according to level of neonatal care at hospital of birth. Pediatrics 2002; 109(5):745-51.
  18. Pilalis A, Souka AP, Antsaklis P, Daskalakis G, Papantoniou N, Mesogitis S, et al. Screening for pre-eclampsia and fetal growth restriction by uterine artery Doppler and PAPP-A at 11-14 weeks' gestation. Ultrasound Obstet Gynecol 2007; 29(2):135-40.
  19. Rizzo G, Capponi A, Cavicchioni O, Vendola M, Arduini D. First trimester uterine Doppler and three-dimensional ultrasound placental volume calculation in predicting pre-eclampsia. Eur J Obstet Gynecol Reprod Biol 2008; 138(2):147-51.
  20. MacGahan JP, Goldberg BB. Diagnostic Ultrasound. 2th ed. New York: Informa Health Care; 2008.