Evaluation Of Uterine and Umbilical Artery Doppler Indices in Normotensive Versus Hypertensive Pregnant Females of Second and Third Trimester
Keywords:
Doppler ultrasonography, Doppler indices, Pulsatility Index (PI), Resistance Index (RI), Systolic-Diastolic (SD) ratio, Gestational-induced hypertension, intrauterine growth restriction (IUGR).Abstract
Background: Hypertensive disorders during pregnancy, including gestational hypertension and preeclampsia, are leading causes of maternal and fetal morbidity and mortality worldwide. Doppler ultrasonography, particularly the measurement of uterine and umbilical artery Doppler indices such as the Pulsatility Index (PI), Resistance Index (RI), and Systolic-Diastolic (SD) ratio, has emerged as an important tool in assessing placental perfusion and fetal well-being in hypertensive pregnancies. However, the clinical value of these indices in distinguishing between normotensive and hypertensive pregnancies remains an area of ongoing research.
Objective: The aim of this study was to evaluate and compare uterine and umbilical artery Doppler indices in normotensive and hypertensive pregnant women during the second and third trimesters, in order to identify potential markers for early detection and improved management of hypertensive disorders in pregnancy.
Methodology: This was a cross-sectional, case-control study conducted at a single center with a total sample size of 80 pregnant women, divided equally between normotensive and hypertensive groups. Doppler ultrasonography was used to measure the PI, RI, and SD ratio in both the uterine and umbilical arteries during the second and third trimesters. Statistical analyses, including independent t-tests and logistic regression, were performed to compare Doppler indices between the two groups and to assess their predictive value for hypertensive disorders.
Results: The study found significant differences between normotensive and hypertensive pregnancies in uterine artery PI (p = 0.0016), with hypertensive pregnancies showing elevated values. The uterine artery RI did not show a significant difference (p = 0.1002), suggesting it may be less sensitive for detecting hypertension. In contrast, there were no significant differences in the umbilical artery PI and RI between the two groups, indicating that these indices might not be as useful for identifying hypertensive pregnancies. The SD ratio was higher in hypertensive pregnancies, but the difference was not statistically significant (p = 0.0733). The logistic regression model for predicting hypertensive pregnancies had moderate accuracy (54.17%), but with low sensitivity (38.46%) and specificity (38.46%).
