NATIONAL JOURNAL OF MEDICAL RESEARCH print ISSN: 2249 4995│eISSN: 2277 8810 Volume 3│Issue 4│Oct – Dec 2013 Page 315 ORIGINAL ARTICLE ROLE OF DOPPLER INDICES IN THE PREDICTION OF ADVERSE PERINATAL OUTCOME IN PREECLAMPSIA Monika Singh 1 , Archana Sharma 2 , Parul Singh 3 Author’s Affiliation: 1 Assistant Professor, Department of Obstetrics & Gynaecology, V.C.S.G. Government Medical Sciences & Research Institute, Srinagar, Pauri Garhwal, Uttarakhand, India; 2 Assistant Professor, Department of Obstetrics & Gynaecology, GMERS Medical College, Dharpur, Patan, Gujarat, India; 3 Senior Resident,Department of Obstetrics and Gynaecology, PGIMS, Rohtak, India Correspondence: Dr. Monika Singh, Email: dr.monika.ms@gmail.com ABSTRACT Objectives: To determine the role of doppler indices in the prediction of perinatal outcome in pre eclampsia. Materials & Methods: A prospective study was conducted at Patna Medical College and Hospital between March 2008-March 2009 on 50 pregnant patients with preeclampsia at ≥32 weeks gestation .All these patients were subjected to a detailed history ,clinical examination and laboratory investigations. Study of fetal vessels was performed serially using a pulsed Doppler ultrasound .Resistance index (RI), pulsatility index(PI) and systolic / diastolic ratio (S/D) were measured in middle cerebral artery (MCA) and umbilical artery (UA). FL/AC (femur length/abdominal circumference) ratio was also measured. Results: 30 patients had IUGR(intrauterine growth restriction). The patients with abnormal indices had higher incidence of caesarean delivery(44%), low apgar score(32%), need for admission to NICU(26%)and neonatal complications(24%)as compared to those with normal indices. Conclusion: Doppler indices were more accurate than FL/AC ratio in the early detection of IUGR. MCA/UA ratios were more accurate than the individual components of MCA and UA.Abnormal Doppler ratios were significant predictors of IUGR and adverse perinatal outcome Keywords: Preeclampsia, IUGR, Doppler, UA,MCA Abbreviations: ACOG- American College of Obstetricians & Gynecologists, BP- Blood pressure, MCA/UA- Middle cerebral artery/Umbilical artery, FL/AC ratio-Femur length/Abdominal Circumference Ratio, IUGR-Intrauterine Growth Restriction MCA-Middle Cerebral Artery, MCA/UA- middle cerebral artery/umbilical artery, NICU- Neonatal intensive care unit, NHBPEP- National High Blood Pressure Education Program, PI- Pulsatility Index RI - Resistance Index, S/D Ratio - Systolic/Diastolic Ratio, SGA- small for gestational age , UA-Umbilical Artery , USG- Ultrasonography. INTRODUCTION Hypertensive disorders complicate 7-10% of all pregnancies [1] . They can be classified into five types according to the Working Group of National High Blood Pressure Education Programme [NHBPEP] and American College of Obstetricians and Gynecologists (ACOG) [2] . Preeclampsia is one of the common condition limiting the availability of substrates necessary for growth of the fetus resulting in IUGR manifesting as birth weight less than 2.5 kg [3] . In preeclampsia there is failure of normal trophoblastic invasion which results in decreased uteroplacental flow. In the initial stages there is sparing of brain growth at the expense of compromise in fetal length [4] . But if the insult continues, brain growth is also compromised. Initially UA S/D ratio increases and MCA S/D decreases indicating placental resistance. Then MCA S/D ratio becomes lower than UA S/D ratio indicating centralization of flow. Next the UA Doppler shows absent and reversal of flow which is associated with adverse perinatal outcome [5] . IUGR can be detected by clinical and ultrasound examination which detects IUGR at a very late stage when the fetus is already compromised, but Doppler can detect it an early stage and help salvage a compromised fetus. OBJECTIVES Objective of the study was to determine the role of doppler indices in the prediction of perinatal outcome in pre eclampsia. MATERIALS AND METHODS The present study was conducted on 50 singleton pregnant patients with preeclampsia at ≥32 weeks