Predicting Adverse Pregnancy Outcomes During the Late First Trimester and Early Second Trimester Using the Uterine Artery Doppler

Abstract

Background: The high resistance occurring in vessels of placenta pathologically can be assessed by impaired blood flow of uterine arteries of pregnant women. It has been proven that measuring of blood flow in the uterine artery in 1st trimester is useful. Results from the second trimester, on the other hand, have proven to be more predictable.

Objective: The aim of the work was to predict fetal and maternal morbidity and mortality as a result of low placental blood flow.

Subjects and Methods: This prospective study included a total of 127 pregnant women, attending for routine first trimester U/S scan at Department of Obstetrics and Gynecology, Zagazig University Hospitals. This study was conducted between April 2020 till December 2020.

Results: The mean Doppler Uterine artery resistance index (RI) was 0.587±0.22 ranged from 0.31 to 1.21 and for pulsatility index (PI) 1.56±0.29 ranged from 0.39 to 2.45. The incidence rate of Fetal maternal adverse outcome was 22.8%, distributed as 11.8% Maternal adverse outcome (most prevailing preeclampsia) and 15.7% Fetal adverse outcome (IUGR and preterm). There was statistically significant higher value of Doppler Uterine artery RI and Doppler Uterine artery PI of Adverse outcome compared to Favorable outcome women. Uterine artery PI was good marker to discriminate maternal fetal adverse outcome at late first to second trimester. While uterine artery RI was fair marker to discriminate maternal fetal adverse outcome at late first to second trimester.

Conclusions: It could be concluded that uterine artery PI was good marker while uterine artery RI was fair marker to discriminate maternal fetal adverse outcome at late first to second trimester.