A study of role of doppler in gestational hypertension and perinatal outcome

Anjali R. Chavda, Parul T. Shah, Rina V. Patel, Hemali N. Patel


Background: Hypertensive disorder of pregnancy is one of the most common complications that affect the human pregnancy. Hence it is important to identify women at risk of developing gestational hypertension or preeclampsia, its early diagnosis and subsequent consequences due to uteroplacental insufficiency with help of Doppler ultrasound, to improve perinatal outcome. The objective of this study was to study the application of Doppler ultrasound with analysis of blood flow velocity waveform in gestational hypertension and to examine and study the perinatal outcome in pregnancy with altered Doppler indices.

Methods: A prospective study was carried out in 50 antenatal patients diagnosed to have gestational hypertension during a period of 12 months to evaluate the role of color Doppler imaging in gestational hypertension in patients more than 28 weeks of gestation, the initial scan was performed immediately after the diagnosis. This study analyzed the blood flow in umbilical artery, maternal uterine artery and fetal middle cerebral artery using Doppler ultrasound.

Results: In this study approximately 76% of cases were found in 20-30 years group. 58% showed abnormal umbilical artery Doppler while 42% women had normal umbilical artery Doppler. In this study 23 cases had cerebro-placental index <1 and 27 cases had cerebro-placental index >1. Cases with cerebro-placental index <1 had various complications like preterm delivery, low birth weight, increased chances of still birth, intra uterine death (IUD), increased NICU admission. In this study 31 cases had abnormal uterine artery Doppler which accounts for 62% of total cases, while 38% had normal uterine artery Doppler.

Conclusions: Doppler ultrasound can reliably predict any adverse fetal outcome in hypertensive pregnancies and can be a useful tool for decision making in appropriate timing of intervention for delivery.


Doppler, Gestational hypertension, Intrauterine growth retardation, Middle cerebral artery, Ultrasound, Umbilical artery, Uterine artery

Full Text:



Zeeman GG, Dekkor GA. Pathogenesis of preeclampsia: a hypothesis. Clin Obstet Gynecol. 1992;35:317-37.

McParland P, Pearce JM, Chamberlain GV. Doppler ultrasound and aspirin in recognition and prevention of pregnancy-induced hypertension. Lancet. 1990;335(8705):1552-5.

Hadda U. Uteroplacental Doppler Ultrasound. Obstet Gynaecol. 1994;4.

Khong TY, De Wolf F, Robertson WB, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre‐eclampsia and by small‐for‐gestational age infants. An Int J Obstet Gynaecol. 1986;93(10):1049-59.

Lin CC, Lindheimer MD, River P. Fetal outcome in hypertensive disorders of pregnancy. Am J Obstet Gynecol. 1982;142:255.

Sibai B, Spinnato JA, Watson DL. Pregnancy outcome in 303 cases with severe preeclampsia. Obstet Gynecol. 1984;64:319-21.

Fleischer A, Schulman H, Farmakides G, Bracero L, Grunfeld L, Rochelson B, Koenigsberg M. Uterine artery Doppler velocimetry in pregnant women with hypertension. Am J Obstet Gynecol. 1986;154:806-13.

Khalid M, Wahab S, Kumar V, Khalid S, Haroon S, Sabzposh NA. Doppler indices in prediction of fetal outcome in hypertensive pregnant women. Nepal J Obstet Gynaecol. 2011;6(1):28-34.

Jackson MR, Walsh AJ, Morrow RJ, Muller BM, Lye SJ, Ritchie JK. Reduced placental villous tree elaboration in small-for-gestational-age pregnancies: relationship with umbilical artery Doppler waveforms. Am J Obstetrics Gynecol. 1995;172(2):518-25.

Lakhkar BN, Rajgopal KN, Gourishankar Pt. Doppler prediction in intrauterine growth retardation IJRI. 2006;16(1):109-16.

Chan FY, Pun TC, Lam P, Lam C, Lee CP, Lam YH. Fetal cerebral Doppler as a predictor of perinatal outcome and subsequent neurological handicap. Obstet Gynecol. 1996;87:981-8.

Fleischer A, Schulman H, Farmakides G, Bracero L, Blattner P, Randolph G. Umbilical artery velocity waveforms and intrauterine restriction. Am J Obstet Gynecol. 1985;151:502-5.

Ebrashy A, Azmy O, Ibrahim M, Waly M, Edris A. Middle cerebral/umbilical artery resistive index as sensitive parameter for fetal wellbeing and neonatal outcome in patients with pre-eclampsia: Casecontrol study. Croat Med J. 2005;46:821-5.