Role of Color Doppler in predicting perinatal outcome in preeclampsia

Anjuri J. Roy, Archana A. Bhosale


Background: Preeclampsia is one of the most common complications of pregnancy, which increases both fetal and maternal mortality and morbidity. Since preeclampsia is characterized by abnormal placenta formation leading to inadequate uteroplacental blood flow, Doppler ultrasonography can prove to be a useful tool to assess fetal outcome in PIH patients. Through this study, we sought to determine the perinatal outcome on the basis of Doppler changes seen in Umbilical and Middle Cerebral artery.

Methods: This was a prospective study conducted from September 2014 to August 2017 in a tertiary care hospital where 150 singleton pregnant patients with preeclampsia were examined with Doppler ultrasound of the Umbilical artery and Middle cerebral Artery. Serial Doppler examination was performed and the results of the last Doppler examination within 10 days of delivery was considered. Perinatal outcome was studied in the form of perinatal death, mean APGAR at 1 and 5 minutes, birth weight and admission to Neonatal Intensive Care Unit (NICU).

Results: Abnormal Doppler velocimetry of the umbilical artery (increased resistance, AEDV, REDV) were significantly associated with poor perinatal outcome in the form of low birth weight, APGAR of ≤7 at five minutes of birth and NICU admission. However, S/D ratio of the Middle cerebral artery could not positively predict poor perinatal outcome in this study.

Conclusions: Doppler technology has provided the best opportunity for repetitive non-invasive hemodynamic monitoring in human pregnancy. Umbilical artery Doppler findings are slight better predictor of adverse perinatal outcome than an abnormal MCA.


Doppler, Preeclampsia, Perinatal outcome, Umbilical artery

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Zeeman GG, Dekker GA. Pathogenesis of preeclampsia: a hypothesis. Clin Obstet Gynecol. 1992 Jun;35(2):317-37.

Brosens IA, Robertson WB, Dixon HG. The role of the spiral arteries in the pathogenesis of preeclampsia. Obstet Gynecol Annu. 1972;1:177-91.

Bhatt, Arora J, Shah M. Role of color doppler in pregnancy induced hypertension (a study of 100 cases). Indian J Radiol Imaging. 2003;13(4):417.

Thaler I, Manor D, Itskovitz J, Rottem S, Levit N, Timor-Tritsch I et al. Changes in uterine blood flow during human pregnancy. Am J Obstet Gynecol. 1990 Jan;162(1):121-5.

Schulman H, Fleischer A, Stern W, Farmakides G, Jagani N, Blattner P. Umbilical velocity wave ratios in human pregnancy. Am J Obstet Gynecol. 1984 Apr;148(7):985-90.

Picconi JL, Hanif F, Drennan K, Mari G. The transitional phase of ductus venosus reversed flow in severely premature IUGR fetuses. Am J Perinatol. 2008 Apr;25(4):199-203.

Giles WB. Vascular Doppler techniques. Obstetrics and Gynecology Clinics. 1999 Dec 1;26(4):595-606.

Bilardo CM, Nicolaides KH, Campbell S. Doppler measurements of fetal and uteroplacental circulations: Relationship with umbilical venous blood gases measured at cordocentesis. Am J Obstet Gynecol. 1990;162(1):115-20.

Yoon BH, Lee CM, Kim SW. An abnormal umbilical artery waveform: a strong and independent predictor of adverse perinatal outcome in patients with preeclampsia. Am J Obstet Gynecol. 1994 Sep;171(3):713-21.

Lalthantluanga C, Devi N, Singh N, Shugeta N, Khuman V, Keishing S. Study on role of obstetrical Doppler in pregnancies with hypertensive disorders of pregnancy. J Med Soc. 2015;29(2):79.

Vedaraju KS, Kanakannavar SS. USG Doppler study of uterine, umbilical and foetal middle cerebral arteries among severe pre-eclamptic women and their relation to perinatal outcomes. Int J Anatomy Radiol Surg. 2016;5(2):14-8.

Yalti S, Oral O, Gurbuz B, Ozden S, Atar F. Ratio of middle cerebral to umbilical artery blood velocity in preeclamptic and hypertensive women in the prediction of poor perinatal outcome. Indian J Med Res. 2004 Jul 1;120(1):44.