To study women at risk of PIH (Primi & Multi) by colour doppler velocimetry of uterine arteries

Abstract

The aim of the study is to study women at risk of PIH (Primi & Multi) by Colour Doppler velocimetry of uterine arteries. Pregnant women attending the antenatal clinics, screened for possible participation in the present study after explaining the nature of the study. A patient was diagnosed to have PIH if there was a rise in systolic pressure of at least 30 mmHg or a diastolic of at least 15 mmHg over the previously known blood pressure or an absolute rise in the blood pressure of at least 140/90 mmHg was taken to diagnose women as a case of PIH. Out of the 100 cases, maximum 35 cases (35%) were low risk primigravidae, followed by cases with history of PIH (15%), obesity (14%), Anemia (10%),Essential hypertension (7%), IUGR (7%),Which constitute 53%. Rest of the cases was family history of hypertension (6%), oligohydromnios (5%) and Twin (1%).Maximum cases i.e. 40% were illiterate, 28% cases were educated up to primary school and only 20% were educated up to middle school and above. Total 60% cases were literate. 77.2% babies were alive, Abortion were 5.3% and 16.76% cases were with poor perinatal outcome. Study shows that 22% cases showed abnormal waveform in colour Doppler, out of which 90.90% developed PIH, while 78% cases were with normal waveform out of which only 10.25% developed PIH later. For prediction of IUGR out of 22% of abnormal waveform 86.36 developed IUGR and out of 78% of normal waveform 20.51% developed IUGR. We conclude that a women with high risk factor (nulliparity and others) having abnormal uterine artery waveforms between 16-28 weeks of gestation (presence of diastolic notch with/without high resistance) are at higher risk of development of PIH (90.90%) and IUGR (95%). An important aspect is the high negative predictive value for PIH (89.74%) and IUGR (78.66%) which helps to detect those patient who will not develop PIH and IUGR early positive prediction enables, one to take preventive measures early thus improving both maternal and perinatal prognosis.