@article{ajcmr20241211,
author={{Ali, Chidiebere Vincent and Ejikeme, Boniface N and Ede, Eziaha E and Orji, Michael Okoh and Olaleye, Ayodele Adegbite and Irechukwu, John C and Okeke, Nwabunike Ekene and Ebere, Chidi Ikenna and Onyekelu, Emmanuel},
title={Second Trimester Uterine Artery Doppler Study as a Predictor of Preeclampsia and Intrauterine Growth Restriction},
journal={American Journal of Clinical Medicine Research},
volume={12},
number={1},
pages={1--12},
year={2024},
url={https://pubs.sciepub.com/ajcmr/12/1/1},
issn={2328-403X},
abstract={<b>Background:</b><b> </b>Impaired placentation with its associated increased impedance to blood flow in the uterine arteries is associated with complications in pregnancy such as pre-eclampsia and intra-uterine growth restriction (IUGR) among others. These complications are identified causes of maternal/perinatal morbidity and mortality. The uterine artery Doppler has potentials for screening for these pathological processes that are associated with impaired placentation. <b>Objective:</b><b> </b>This study was designed to evaluate the predictive value of Doppler investigations of the uterine circulation in the second trimester (20-24 weeks of gestation) with regard to the development of some pregnancy complications such as pre-eclampsia and IUGR. <b>Methods:</b><b> </b>This was a prospective longitudinal cross-sectional study of 354 low-risk women attending antenatal care at Alex Ekwueme Federal University Teaching Hospital Abakaliki. The study population was subjected to uterine artery Doppler study at 20-24 weeks gestation. The mean uterine artery Doppler indices such as pulsatitity index (PI), resistance index (RI) and presence of early diastolic notch (EDN) were obtained, and the outcomes of pre-eclampsia and intra-uterine growth restriction (IUGR) were studied. Data analysis was done using statistical package for social science (IBMSPSS) software (version 21, Chicago II, USA) at a statistical significance level of p &lt; 0.05. <b>Results:</b><b> </b>Out of the 354 women, 21(5.9%) developed pre-eclampsia and 27 (7.6% developed intra-uterine growth restriction. For pre-eclampsia, the resistance index showed a sensitivity of 66.7%, specificity of 91.9%, positive predictive value (PPV) of 34.2% and negative predictive value (NPV) of 97.8%; its pulsatility index showed a sensitivity of 71.4%, specificity of 95.5%, PPV of 50.0% and NPV of 98.2%; while for early diastolic notch had sensitivity of 66.7%, specificity of 94.3%, PPV of 42.4% and NPV of 97.8%. For intra-uterine growth restriction, resistance index showed a sensitivity of 59.3%, specificity of 92.4%, PPV of 39.0% and NPV of 96.5%; pulsatility index showed a sensitivity of 77.8%, specificity of 97.3%, PPV of 70.0% and NPV of 98.2%; while early diastolic notch had a sensitivity of 85.2%, specificity of 96.9%, PPV of 69.7% and NPV of 98.8%. <b>Conclusion:</b><b> </b>The high negative predictive values indicated that women with normal Doppler velocimetry were unlikely to develop pre-eclampsia or intra-uterine growth restriction. Uterine artery Doppler, being non-invasive, can be included during routine sonography to identify patients at risk of developing pre-eclampsia or intra-uterine growth restriction. Early screening for pre-eclampsia and intra-uterine growth restriction will help in individualized antenatal surveillance and initiation of prophylactic therapy, and will help to reduce the adverse maternal and foetal complications of pre-eclampsia and intra-uterine growth restriction.},
doi={10.12691/ajcmr-12-1-1}
publisher={Science and Education Publishing}
}