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Category: Volume 08 Issue 01 January 2020
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Title: Evaluation of Fetal Doppler Indices in Patients with Pregancy Induced Hypertension and Healthy Pregnant Patients with Impact on Fetal Growth

Authors: Navneet Kaur Risam, Sheema Posh, Sheetal Sharma, Sajjad Ahmad Dar

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.61

Abstract

Introduction

Doppler study of the uteroplacental circulation was first suggested as a method of pregnancy assessment by Campbell and colleagues,¹ who observed that Doppler flow velocity waveforms (FVW) were abnormal in pregnancies complicated by pregnancy-induced hypertension (PIH) and intrauterine growth retardation. In recent years a number of Doppler ultrasound studies of the uteroplacental circulation have confirmed the original observation that increased impedance to flowin these vessels is associated with an increased risk for subsequent development of pre-eclampsia and/or FGR.2. IUGR is thought to be the consequence of impaired trophoblastic invasion of the maternal spiral arteries and the physiological reduction in vascular resistance in the uteroplacental circulation 1,3-7.

It is essential to accurately predict intrauterine growth restriction to facilitate monitoring and preventive treatment so that better maternal and perinatal outcome is achieved8. Women with normal uterine artery Doppler results are unlikely to develop preeclampsia, FGR or placental abruption and therefore do not necessarily need antenatal follow-up that is as close as that required in women with abnormal uterine artery Doppler findings9.

References

  1. Campbell S, Diaz-Recasens J, Griffin D, et al. New doppler technique for assessing uteroplacental blood flow. Lancet 1983; 1: 675-79
  2. Campbell S, Pearce JM, Hackett G, Cohen-Overbeek T, Hernandez C.Qualitative assessment of uteroplacental blood flow: early screeningtest for high-risk pregnancies. ObstetGynecol1986; 68: 649–53
  3. Brosens I, Robertson WB, Dixon HG. The physiological response of the vessels of the placental bed to normal pregnancy. J PatholBacteriol1967; 93: 569–79
  4. Pijnenborg R, Bland JM, Robertson WB, Brosens I. Uteroplacental arterial changes related to interstitial trophoblastic migration in early human pregnancy. Placenta 1983; 4: 397–14
  5. McParland P, Pearce JM. Doppler blood flow in pregnancy. Placenta 1988; 9: 427–50
  6. Khong TY, De Wolf F, Robertson WB, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J ObstetGynaecol1986; 93: 1049–59
  7. Aardema MW, Oosterhof H, Timmer A, Rooy I, Aarnoudse JG. Uterine artery Doppler flow and uteroplacental vascular pathology in normal pregnancies and pregnancies complicated by pre-eclampsia and small for gestational age fetuses. Placenta 2001; 22: 405–11
  8. Coomarasamy A, Papaioannou S, Gee H, et al. Aspirin for the prevention of preeclampsia in women with abnormal uterine artery Doppler: a meta-analysis. ObstetGynecol2001;98:861-6.
  9. Albaiges G, Missfelder-Lobos H, Lees C et al. One-stage screening for pregnancy complicayions by colour Doppler assessment of uterine ateries at 23 weeks of gestational age.Obstet Gynecol. Oct 2000; 96 (4): 559-64
  10. Papageorghiou AT, Yu CKH, Bindra R et. Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation. Ultrasound Obstetgynecol 18: 441-449.

Corresponding Author

Sheema Posh

Senior Resident, Department of Obstetrics and Gynecology, Skims, Srinagar