Correlation of placental laterality and uterine artery Doppler in pre-eclampsia

Authors

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231766

Keywords:

Placental laterality, Uterine artery Doppler, Pre-eclampsia

Abstract

Background: Pre-eclampsia is a complex condition associated with maternal and fetal mortality and morbidity. Various screening tests have been proposed for the prediction of pre-eclampsia with varying results. Non-invasive doppler velocimetry studies of uterine arteries in second trimester with abnormal forms can predict the occurrence of pre-eclampsia. This abnormal wave forms indicate defective uterine perfusion and is consequence of placental implantation laterally. The objective of this study was to correlate placental laterality and uterine artery doppler in pre-eclampsia.

Methods: It was prospective study from November 2019 to March 2021 at M S Ramaiah medical college and hospitals, Bangalore.

Results: In the present study, preeclampsia was seen in 36.5 % with lateral location of placenta, 19.3% with posterior location of placenta and 15.9% with anterior location of placenta. This was statistically significant with p<0.001. Uterine artery doppler, the pulsatality index (PI) was <95th centile in 88.1% and 11.9% had >95th centile The subjects with PI >95th centile, 65.5% developed preeclampsia and <95th centile, 13.1% developed pre-eclampsia. This was statistically significant. In this study, with PI at 1.68, the sensitivity was 53.19%, specificity was 92.86%, positive predictive value (PPV) of 64.1% and negative predictive value (NPV) was 89.2%.

Conclusions: USG is a simple, non-invasive, easy to perform and cost-effective method to locate the placenta. Every attempt should be made to do Uterine artery doppler at the same sitting. Both these are non-invasive and can predict the occurrence of pre-eclampsia. These patients can be managed as high risk and monitored more carefully. Surveillance will help in decreasing maternal and perinatal mortality and morbidity.

References

Balerao AV, Kulkarni S, Somalwar S. Lateral Placentation by Ultrasonography: A Simple Predictor of Preeclampsia. J South Asian Feder Obst Gynae. 2013;5(2):68-71.

Huppetz B. Plactenat Origins of Preeclampsia Challenging the Hypothesis. Hypertension. 2008;51:970-75.

Shivamurthy HM, Sharada KS, Giridhar SA, Himgire JR, Asaranna D. Placental laterality as a predictor of pre-eclampsia-An ultrasonic prospective study. J Pub Health Med Res. 2014;2(1):38-40.

Yousuf S, Ahmad A, Qadir S, Gul S, Tali SH, Shaheen F, et al. Utility of placental laterality and uterine artery Doppler abnormalities for prediction of preeclampsia. J Obstetr Gynecol India. 2016;66:212-6.

Pillay R, Sanam P. Association of Lateral Implantation of Placenta with Development of Pre-Eclampsia: A Prospective Study. J Evidence Based Med Healthcare. 2015;2(10):1504-8.

Aggarwal P, Kangjam P, Terhase N. Study on relation between placental laterality in second trimester ultrasound and development of preeclampsia at term. J Evolution Med Dental Scis. 2015;4(104):16926-9.

Chandra K, Maheshwari S. Placental laterality: as a predictor for the development of pre-eclampsia. J Dent Med Sci. 2016;15:6-10.

Pai MV, Pillai J. Placental laterality by ultrasound–a simple yet reliable predictive test for preeclampsia. J Obstetr Gynecol India. 2005;55(5):431-3.

Kore SJ, Khot R, Supe P, Kanavia D, Thunga C, Nandanwar Y. Prediction of pre-eclampsia: role of placental laterality by ultrasonography. Int J Reproduct Contracep Obstetr Gynecol. 2016;5(5):1433-8.

Bhattacharjee AK, Majumdar MK, Lucky B. Placental laterality by ultrasound and its correlation to development of preeclampsia. Sch J App Med Sci. 2017;5(10F):4197-200.

ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. Am College Obstetr Gynecologists. 2002;;77(1):67-75.

Sandhya K, Madhavi GB, Chandramathi M. Placental laterality as a predictor of pre-eclampsiа. Am J Phytomed Clin Ther. 2015;3(3):231-6.

Sumathi N, Pavithra GR. Placental Laterality-A Simple yet reliable predictor of pre-eclampsia an ultrasonic prospective study. IOSR-JDMS. 2016;15(10):116-21.

Kannamani A, Narasimhan D. A study on analysis of validity of lateral placental location in prediction of preeclampsia. J Evolution Med Dental Sci. 2017;6(18):1401-4.

Gosh M, Gosh A, Sengupta P. A study to assess placental location by ultrasonography and evaluation of its relationship with development of preeclampsia and eclampsia. Int J Biomed Res. 2017;8:668-71.

Priyadarshini A, Upreti P, Nautiyal R, Goyal M. Placental location and development of preeclampsia: a longitudinal study. Int J Reprod Contracept Obstet Gynecol. 2019;8(4):2320-1770.

Patni M, Jain M, Rajoria L, Gupta S, Vyas G, Saini M. A Prospective Study to Assess Placental Location by Ultrasonography at 18-24 Weeks of Pregnancy and it’s Relationship with Development of Hypertensive Disease of Pregnancy. Int J Med Res Prof. 2018; 4(6):211-15.

Ghadei R, Mohanty GS. Placental laterality as a predictor of preeclampsia. J Evolution Med Dental Sci. 2017;6(35):2885-8.

Kakkar T, Singh V, Razdan R, Digra SK, Gupta A, Kakkar M. Placental laterality as a predictor for development of preeclampsia. J Obstetr Gynecol India. 2013;63:22-5.

Barati M, Shahbazian N, Ahmadi L, Masihi S. Diagnostic evaluation of uterine artery Doppler sonography for the prediction of adverse pregnancy outcomes. J Res Med Sci. 2014;19(6):515.

Kofinas AD, Penry M, Swain M, Hatjis CG. Effect of placental laterality on uterine artery resistance and development of preeclampsia and intrauterine growth retardation. Am J Obstetr Gynecol. 1989;161(6):1536-9.

Kofinas AD, Penry M, Greiss Jr FC, Meis PJ, Nelson LH. The effect of placental location on uterine artery flow velocity waveforms. Am J Obstetr Gynecol. 1988;159(6):1504-8.

Rodriguez-Lopez M, Wagner P, Perez-Vicente R, Crispi F, Merlo J. Revisiting the discriminatory accuracy of traditional risk factors in preeclampsia screening. PLoS One. 2017;12(5):e0178528.

Ritukamra HD, Gupta KD, Natu SM. Role of Urinary calcium/creatinine ratio prediction of PIH. J Obset Gynecol India. 1997;47(4).

Sanchez-Ramos LU, Sandroni ST, Andres FJ, Kaunitz AM. Calcium excretion in preeclampsia. Obstetr Gynecol. 1991;77(4):510-3.

Ozcan T, Rinder HM, Murphy J, Kohn C, Copel JA, Magriples U. Genetic thrombophilia and hypertensive complications of pregnancy. Obstetr Gynecol. 2001;97(4):S40.

Cnossen JS, Morris RK, Ter Riet G, Mol BW, Van Der Post JA, Coomarasamy A, et al. Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ. 2008;178(6):701-11.

Papageorghiou AT, Christina KH, Nicolaides KH. The role of uterine artery Doppler in predicting adverse pregnancy outcome. Best Pract Res Clin Obstetr Gynaecol. 2004;18(3):383-96.

Ratanasiri T. Prediction of preeclampsia in a low-risk population using diastolic notch of uterine arteries. J Med Asso Thailand= Chotmaihet Thangphaet. 2004;87:S29-33.

Espinoza J, Kusanovic JP, Bahado-Singh R, Gervasi MT, Romero R, Lee W, et al. Should bilateral uterine artery notching be used in the risk assessment for preeclampsia, small‐for‐gestational‐age, and gestational hypertension? J Ultrasound Med. 2010;29(7):1103-15.

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Published

2023-06-05

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Original Research Articles