Journal des soins de santé des femmes
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Comparison of the Umbilical Artery Doppler Indices in Predicting Adverse Fetal Outcome in Women with Preeclampsia

Omoregie Irowa*, Hameed Mohammad, Michael Ijiko, Joseph Chiahemba Agulebe, Franklin Emeke Osagie

Background: Umbilical artery Doppler (UAD) is a non-invasive method of antenatal fetal surveillance for detecting hemodynamic changes prior to the occurrence of adverse fetal outcome and thus useful for averting adverse fetal outcome in preeclampsia. This study aims to compare the umbilical artery Doppler PI, RI, S/D ratio in predicting adverse fetal outcome in women with preeclampsia.

Methods: This was a prospective observational study in which 170 consecutively consenting women with preeclampsia were recruited. An UAD was done using Voluson P8 ultrasound. The Pulsatility Index (PI), Resistance Index (RI), Systolic/Diastole (S/D) ratio, was measured. The participants were divided into two groups based on UAD indices findings. Both groups were followed up to determine their fetal outcome. The data was analyzed using SPSS version 20.0 for windows (IBM SPSS Inc, Chicago, IL, USA). Categorical variables were analyzed using Chi-Square (x2) test and Fisher's exact test. The sensitivity, specificity, PPV and NPV of UAD PI, RI S/D ratio were determined.

Results: This study found that UAD PI was most sensitive in predicting IUGR (75.4%) and Apgar score <7 (80.0%) in women with preeclampsia. The UAD S/D ratio (62.0%) was the most sensitive in predicting low birth weight. UAD PI and RI have similar sensitivity of 74.2% in predicting preterm delivery.

Conclusion: The UAD PI was the most reliable individual indices in predicting adverse fetal outcome and thus, recommends its use alone or in combination of with other indices in predicting adverse fetal outcome in preeclampsia.