Placental Blood Flow and Uterine Artery Doppler in Early Prediction of Preeclampsia_

Document Type : Original Article

Authors

1 Professor of Obstetrics & Gynecology Faculty of Medicine- Menoufia University

2 Assistant Professor of Obstetrics & Gynecology, Faculty of Medicine- Menoufia University

3 Resident in Obstetrics & Gynecology Department El-Sahel Teaching Hospital

Abstract

Background: Preeclampsia is a serious hypertensive disorder that develops during pregnancy and impacts ap-proximately 5-8% of pregnancies worldwide. Hyperten-sion (high blood pressure) is a characteristic of this condi-tion that manifests after the 20th week of gestation and is frequently accompanied by organ dysfunction, primarily affecting the placenta and the mother's kidneys, liver, and cardiovascular system.    
Objective: To the understanding of this complex disorder and potentially improve its early detection and manage-ment.    
Patients and Methods: This prospective observation-al study was conducted on 183 primigravida women, of them 176 women completed the follow up till the end of the study. Placental volume and vascularization indices were obtained between 11 and 13.6 weeks and calculat-ed by three-dimensional Doppler histogram. We mea-sured the uterine artery doppler during first trimester (be-tween11 and 13.6 weeks) and second trimester (between 20 and 24 weeks) and examined their association with the subsequent development of preeclampsia. 
Results: Of the 176 pregnant women studied, 18 (10.23%) developed preeclampsia, this study findings revealed that the women with preeclampsia had significantly low pla-cental volume and low placental vascular incidences (vas-cularisation index VI, flow index FI, vascularisation flow index VFI) compared with the normotensive women. In contrast, the women with preeclampsia had significantly higher mean uterine artery plustility index and resistance index than the normotensive women. By comparing our study results to the findings of related studies focusing on placental volume, vascularisation of placenta and uterine artery Doppler, we can strengthen the evidence support-ing the association between these parameters and the de-velopment of preeclampsia.
Conclusion: This study revealed that multivariate logis-tic regression analysis demonstrated that The first trimes-ter's preeclampsia was significantly predicted by uterine artery PI, placental volume, and vascularization index, as evidenced by a p-value of less than 0.05. The most precise predictors of preeclampsia in the analyzed population were the combined placental volume, placental vascularization index, and first-trimester uterine artery PI, giving the highest predictive accuracy of 95.5%.

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