Validation Of Uterine Artery Doppler In Predicting Intra-Uterine Growth Restriction Among Pregnant Women With Pre-Existing Hypertension

ABSTRACT Hypertensive disorders complicate 12% to 22% of all pregnancies. Intrauterine growth restriction is one of the fetal outcomes in mothers with hypertension. Doppler studies are done to predict pregnancy outcome in patients with hypertension. We planned this study to determine the role of uterine artery Doppler at 22 to 26 weeks of gestation for predicting IUGR in women with pre-existing hypertension. A cross sectional validation study was undertaken in the Department of Obstetrics & Gynaecology, MCH Center, Unit I, PIMS, Islamabad from June 2014 to June 2015. Both primigravida and multigravida women with pre-existing hypertension were enrolled. Pregnancies with congenital abnormalities, complications like diabetes, cardiac disease and autoimmune disease were excluded. Women without satisfactory attainment of sonography due to technical reasons, lost to follow-up and cases who were not delivered in MCH Center, PIMS, were also excluded. There were 15 (26.7%) cases of IUGR in normal RI Doppler group and 20 (35.7%) abnormal RI Doppler group. The average birth weight was slightly higher in normal RI group 2.9 + 1.1 kg compared to 2.3 + 0.7 kg in abnormal RI group. RI on Doppler ultrasound had sensitivity and specificity of 57.1% and 53.2% in predicting IUGR whereas the PPV and NPV were found to be 35.7% and 73.2% respectively. RI on Doppler ultrasound is a reasonably good predictor of IUGR. Though it was reasonably sensitive the value of PPV was not that high (35.7%). Keywords; Pregnancy, pre-existing hypertension, uterine artery Doppler, IUGR