Prognostic Value of Doppler Ultrasound in Pre-eclampsia at Tripoli University Hospital (2007-2009)

الملخص

Doppler ultrasound provides a non-invasive method for the study of fetal hemodynamic. Investigation of the uterine and umbilical arteries gives information on the perfusion of the uteroplacental and fetoplacental circulations.
The study aimed to investigate the prognostic value of Doppler ultra sound in assessment of fetal wellbeing in
pre-eclamptic pregnant women, and to study the correlation between pulsatility index of umbilical artery, middle
cerebral artery, and perinatal outcome in pregnancy with pre-eclampsia. This was a prospective observational
study; conducted in Obstetrics and Gynecology Department at Tripoli University Hospital, which includes pregnant
women with pre-eclampsia with or without intrauterine growth restriction (IUGR) from January 2007 to December
2009. Variables include umbilical and middle cerebral artery pulsatile index (for fetal outcome), uric acid level,
a gestational age at delivery, time interval between last Doppler examination and delivery, Apgar score, and birth
weight. A total of 402 patients completed the study, the age ranged from 20-45 years old. The perinatal mortality rate was 6.5%, increased with increase serum uric acid level, and most of babies were preterm (32-34 weeks
of gestation) with high perinatal death. The majority of umbilical artery pulsatile index (UMAPI) within normal
centile (5th- 95th) with perinatal death of 6%; while the perinatal death of 7.2% were associated with abnormal
UMAPI centile, inabnormal middle cerebral artery pulsatile index (MCAPI) centile (<5th) with the perinatal death
were 52.2%, among normal MCAPI centile (5th ->95th) the perinatal death was 3.7%. The perinatal death increased
with birth weight centile <5th centile to 20%, and babies low Apgar score at 5 minutes of delivery with high perinatal death of 68.4%. This study indicates that the Doppler ultrasound is a noninvasive method for study of fetal
hemodynamics to give information on the perfusion of the fetoplacental circulation. MCAPI is more sensitive for
the perinatal outcome.