Prediction of pre-eclampsia by a combination of maternal history, uterine artery Doppler, and mean arterial pressure (a prospective study of 200 cases)

Objective: To determine the clinical value of uterine artery Doppler Pulsatility index (PI) at 22-24 + 6 weeks scan and importance of maternal history and mean arterial pressure (MAP) in the prediction of pre-eclampsia.

Materials and methods: This was a prospective screening study of 200 women with singleton pregnancy. Maternal history and blood pressure were recorded, and MAP was calculated. Transabdominal Doppler ultrasound of uterine artery was performed. Mean PI was calculated, and the presence or the absence of bilateral early diastolic notch was noted. Women were then followed up through pregnancy and delivery for the development of pre-eclampsia, gestational hypertension, and SGA.

Results: The mean ± SD PI value for subjects who had an adverse pregnancy outcome was significantly higher (0.84 ± 0.28) than mean ± SD PI value for subjects who had normal pregnancy outcome (0.71 ± 0.16) with P value <0.000.

Conclusion: Second trimester uterine artery Doppler is a useful screening method for identification of high risk pregnancy in women who can be kept under close surveillance for better maternal and neonatal outcome. This test works better when combined with previous history of pre-eclampsia and MAP.