RESUMO
Background Hypertensive disorders of pregnancy (HDP) pose significant risks to maternal and fetal health. The utility of Doppler indices in predicting adverse fetal outcomes in HDP patients remains an area of active research. This observational study aimed to assess the correlation between abnormal uterine artery Doppler indices and adverse fetal outcomes in HDP patients. Methods Over a two-year period, we enrolled 138 pregnant women with HDP beyond 28 weeks of gestation and singleton pregnancies. Detailed clinical assessments, laboratory investigations, and Doppler studies of the uterine artery were conducted. The Doppler indices that were assessed included the systolic/diastolic (S/D) ratio, resistance index (RI), and pulsatility index (PI). Adverse fetal outcomes were classified based on appearance, pulse, grimace, activity, and respiration (APGAR) scores, birth weight, NICU admissions, and perinatal deaths. Statistical analyses were performed to evaluate the predictive value of Doppler indices. Results Abnormal uterine artery Doppler indices, specifically an elevated S/D ratio and the presence of a diastolic notch showed a positive correlation with adverse fetal outcomes. However, Doppler indices such as PI and RI did not demonstrate a significant correlation with adverse fetal outcomes in HDP patients. These findings suggest that the S/D ratio and the presence of a diastolic notch in uterine artery Doppler studies hold potential as predictive markers for adverse fetal outcomes in HDP patients. Conclusion Uterine artery Doppler indices, specifically the S/D ratio and the presence of a diastolic notch, appear to be valuable predictors for adverse fetal outcomes in patients with hypertensive disorders of pregnancy. These findings underscore the importance of regular monitoring of uterine artery Doppler flow in the management of HDP to identify pregnancies at higher risk for adverse fetal outcomes.
RESUMO
Background Hypertensive disorders of pregnancy (HDP) are associated with increased maternal and fetal risks. Doppler ultrasound indices of the umbilical artery have shown promise in predicting adverse fetal outcomes in HDP patients. This observational study investigated the correlation between abnormal umbilical artery Doppler indices and adverse fetal outcomes in HDP patients. Methodology Over a two-year period from 2020 to 2022, in Acharya Vinoba Bhave Rural Hospital, central India, we enrolled 138 pregnant women with HDP beyond 28 weeks of gestation and singleton pregnancies. Comprehensive clinical assessments, laboratory investigations, and Doppler studies of the umbilical artery were performed. Doppler indices assessed included the systolic/diastolic (S/D) ratio, resistance index (RI), and pulsatility index (PI). Adverse fetal outcomes were defined based on birth weight and neonatal intensive care unit admissions. Chi-square or Fisher's exact test was used for analyzing the relationship between qualitative data, while an independent-sample t-test was employed for quantitative data. Results Abnormal umbilical artery Doppler indices, including an elevated S/D ratio, RI, and PI, demonstrated a positive correlation with adverse fetal outcomes in HDP patients. These findings highlight the significance of umbilical artery Doppler indices as reliable indicators for anticipating adverse fetal outcomes in HDP patients. Conclusions Abnormal Doppler indices in the umbilical artery, including an elevated S/D ratio, RI, and PI, appear to be valuable predictors for adverse fetal outcomes in patients with HDP. Monitoring these indices can aid in risk stratification and improve the management of pregnancies complicated by HDP.