Evaluation of Uterine Artery Doppler (Mean Pulsatility Index) at 11–14 Weeks of Gestation as Predictor of Hypertensive Disorders of Pregnancy: A Prospective Observational Study

摘要

Background The etiology and pathophysiology of hypertensive disorders of pregnancy remains enigmatic, and till date, no test can accurately predict it. Early screening may allow vigilant antenatal surveillance, timely delivery and thus substantially reduce maternal and perinatal morbidity and mortality. Our study aims to evaluate the predictive value of uterine artery mean pulsatility index (PI) at 11–14 weeks and fnd a reference value for hypertensive disorders of pregnancy. Methods A prospective study of 240 antenatal women using non-probability simple random sampling was carried out in a tertiary care center. Mean uterine artery PI was obtained at 11–14 weeks of gestation. Pregnancies were followed till delivery and 7 days postpartum. The major end point was development of hypertensive disorders of pregnancy. Maternal and neonatal outcomes were also assessed. Results The predictability of uterine artery mean pulsatility index (PI) at 11–14 weeks for hypertensive disorders of pregnancy was signifcantly high with an odds ratio of 174.45 (95% CI 65.31–549.13; p0.0001), sensitivity (89.3%), specifcity (95.8%), positive predictive value(90.5%) and negative predictive value (95.1%). Conclusion Uterine artery mean PI at 11–14 weeks of gestation is a cost-efective predictive test for hypertensive disorders of pregnancy, and the recommended reference value for Indian population of is 2.28.