N. Uma1, D. Hemalata Devi2, P. Usha3, D. Jyotsna4, A. Bhagya Lakshmi5
BACKGROUND: The Doppler velocimetry has become an important tool in the evaluation and management of high-risk pregnancies. The umbilical and uterine artery Doppler abnormalities can detect abnormal feto-placental circulation. Recently MCA to Umbilical Artery (UA) pulsatility index (PI) ratio have been described to be good predictors of neonatal outcome in high risk pregnancies in the third trimester and have been proposed to identify fetuses at risk of morbidity and mortality.
AIM: To know the relationship of MCA-PI (Middle cerebral arteryPulsatility Index), UA-PI (Umbilical artery- Pulsatility Index) and ratio of MCA-PI/UA-PI on the outcome of pregnancy in high risk cases.
METHOD OF STUDY: Analytical study at tertiary care centre on 60 pregnant women in third trimester of pregnancy with associated risk factors of intrauterine growth retardation, pregnancy induced hypertension or preeclampsia were included in the study. Doppler evaluations were performed from diagnosis to delivery with weekly follow up. MCA-PI (Middle cerebral artery- Pulsatility Index), UA-PI (Uterine artery- Pulsatility Index) were recorded. The perinatal out-come were noted and calculated for level of significance.
RESULTS: Abnormal UA– PI is significantly associated with operative intervention and poor perinatal outcome. But UA-PI is not sensitive. Abnormal MCA - PI though, moderately significant in association with operative intervention; association with perinatal complications is not significant. The ratio of MCA-PI/UAPI; those with ratio of <1and <1.1, are associated with operative intervention and also poor perinatal outcome with high significance.
CONCLUSIONS: High risk pregnancy requires close follow up . Fetal doppler provides more accurate assessment of fetal wellbeing .Of all the tests, ratio of MCA-PI/UA-PI is a more dependable index; ratio of <1 and <1.1 is associated with operative intervention and perinatal complications with high significance, good specificity and moderate sensitivity.
