International Journal of Medical Science and Public Health 1330 2017 | Vol 6 | Issue 8 International Journal of Medical Science and Public Health 1330 2017 | Vol 6 | Issue 8
A prospective study of role of color Doppler in high-risk pregnancies in a
tertiary care hospital
Dhara Shah
1
, Chinmay Shah
1
, Mona Shastri
2
, Ekta Desai
2
, Dhagash Patel
2
, Mona Chitara
2
1
Consultant Radiologist, Surat, Gujarat, India,
2
Department of Radiodiagnosis, Surat Municipal Institute of Medical Education and Research,
Surat, Gujarat, India
Correspondence to: Dhara Shah, E-mail: drdharashah@yahoo.com
Received: May 12, 2017; Accepted: June 15, 2017
INTRODUCTION
Pregnancy can be considered as the most beautiful period
of a woman’s life. The recent medical advances are helpful
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DOI: 10.5455/ijmsph.2017.0512515062017
in taking very good care of the female throughout her
pregnancy. The pregnancy is constantly observed by clinical
examination, laboratory investigations, and radiographic
examinations at specific intervals throughout its course. The
use of Doppler ultrasound has been recently introduced for
the study of fetal circulation and various vessels including
the both uterine artery, umbilical artery, and middle cerebral
artery (MCA).
In obstetrics, the use of Doppler ultrasound to study blood flow
is of major importance because fetal inaccessibility precludes
many other methods of the study of fetal hemodynamics.
Background: High-risk pregnancies are associated with many adverse perinatal outcomes. The use of Doppler ultrasound offers a
non-invasive way to study the fetal and maternal circulation and guide the clinical management. Objective: The aim of this study
is to evaluate the role of color Doppler in the effective management of high-risk pregnancies. Materials and Methods: This was
a prospective and observational study carried out for 2 years in the Department of Radiology with the help of the Department
of Obstetrics and Gynecology. Antenatal women in the age group of 20-30 years with singleton pregnancy of gestational age of
26 weeks to term and presence of one of the high-risk factors were enrolled in the study. The risk factors considered were pregnancy-
induced hypertension (PIH), diabetes, anemia, oligohydramnios, toxoplasmosis, and hepatitis. Doppler study of umbilical artery,
fetal middle cerebral artery (MCA), and both the maternal uterine arteries was done. Parameters in the form of resistive index,
pulsatility index, and systolic/diastolic ratio were taken. Details of obstetric history and delivery were taken. Patients were followed
up at regular intervals. Results: A total of 110 cases were enrolled in the study. High-risk pregnancy was more common in the age
group of 20-25 years. The most common high-risk factor in pregnancy was PIH which accounted for 49% of cases. Out of 110
high-risk pregnancies, 39% (n = 43) of cases resulted in intrauterine growth restriction (IUGR). PIH, anemia, and diabetes were
more associated with IUGR as compared to oligohydramnios, hepatitis, and toxoplasmosis. Out of 110 high-risk cases, in 43%
(n = 47) cases, umbilical artery findings were abnormal. 38% of cases of isolated fetoplacental insufficiency without uteroplacental
insufficiency were more associated with intrauterine death. Isolated umbilical artery abnormality was more associated with adverse
perinatal outcomes (72%) than isolated MCA abnormality. Survivability of fetus increased when early induction or lower (uterine)
segment caesarian section was done on emergency basis. Conclusion: Doppler can be used as a reliable tool for fetal surveillance
in high-risk pregnancy cases. It helps in guiding early intervention and improving fetal outcome.
KEY WORDS: Doppler Ultrasound; Gestational Hypertension; High-risk Pregnancy; Perinatal Outcome
International Journal of Medical Science and Public Health Online 2017. © 2017 Dhara Shah>. This is an Open Access article distributed under the terms of the Creative Commons
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Research Article
ABSTRACT