ROLE OF THIRD‑TRIMESTER DOPPLER VELOCIMETRY IN PREDICTING PERINATAL OUTCOME IN HIGH‑RISK PREGNANCIES: A PROSPECTIVE STUDY.
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Keywords
Doppler velocimetry, high-risk pregnancy, perinatal outcome, cerebroplacental ratio, umbilical artery
Abstract
Third-trimester Doppler velocimetry offers a timely pathophysiological information on the fetal health in high-risk pregnancy, in which conventional surveillance usually indicates compromising health at too late a stage. This prospective study compared uterine, umbilical, and middle cerebral artery Doppler measurements with perinatal outcomes, in 120 cases of high risks, in a tertiary care centre.
Methods: Observation of singleton pregnancies (30-34 weeks) in the hospital with the risks of hypertensive disorders and growth restriction. Doppler indices were measured according to the gestational norms; composite adverse outcome was measured as preterm delivery, low birth weight, low Apgar, NICU stay 24h, or perinatal death.
Results: Abnormal Doppler was found in 40% of cases where multivessel involvement predicts 80% composite adverse outcome compared to 12.5% when normal. Abnormal umbilical artery was associated with increased preterm (55.6%), low birth weight (72.2%), and perinatal death (16.7%).
Conclusions: Multivessel third-trimester Doppler is an effective stratification of perinatal risk and needs to be integrated with clinical care to maximize the time of action and minimize morbidity in resource-constrained environments.
References
2. Basgul A, Kavak ZN, Gulmezoglu AM, et al. The role of uterine and umbilical arterial Doppler in high‑risk pregnancies. J Obstet Gynaecol Res. 2015;41(4):510‑516.
3. Sood AK, et al. Abnormal umbilical artery Doppler in third trimester and its association with perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 1999;
4. Poulain P, et al. Fetal umbilical Doppler in a population of 541 high‑risk pregnancies. Eur J Obstet Gynecol Reprod Biol. 1994;54(1):23‑28.
5. Alfirevic Z, Stampalija T, Gyte GM. Fetal and umbilical Doppler ultrasound in high‑risk pregnancies. Cochrane Database Syst Rev. 2010;(1):CD007529.
6. Singh R, et al. Prediction of perinatal outcome in high‑risk pregnancy by Doppler velocimetry of uterine, umbilical and middle cerebral arteries. Int J Reprod Contracept Obstet Gynecol. 2022;11(9)
7. Rao PS, et al. Doppler study in high‑risk pregnancies in third trimester for prediction of adverse perinatal outcome. J Evid Based Med Healthc. 2016;3(—)
8. Sehgal A, et al. The Doppler study on umbilical and fetal middle cerebral arteries in high‑risk pregnancies and correlation with perinatal outcome. Int J Curr Pharm Res. 2021;13(3)
9. Morris RK, et al. Systematic review and meta‑analysis of the test accuracy of ductus venosus Doppler to predict compromise of fetal/neonatal wellbeing and perinatal mortality. Ultrasound Obstet Gynecol. 2010;36(5):582‑590.
10. Khalil A, et al. The role of ductus venosus Doppler in monitoring high‑risk pregnancies: a systematic review. Health Technol Assess. 2010;14(—):1‑134.
11. Lakshmi KS, et al. Correlation between fetal ductus venosus Doppler velocimetry, cerebroplacental ratio and perinatal outcome in preeclamptic pregnancies. Ginekol Pol. 2022;93(6)
12. Deora S, et al. Non‑stress test as a predictor for high‑risk pregnancy: comparison with color Doppler. Health Care Bull. 2021;9
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Dr. Khushboo Soni
Senior Resident, Department of Obstetrics & Gynecology, Shyam Shah Medical College, Rewa (M.P.)
Dr. Kavita Devi
P.G. Resident, Department of Obstetrics & Gynecology, Shyam Shah Medical College, Rewa (M.P.)
