Role of Uterine and Ophthalmic Artery Doppler Velocimetry in Second Trimester for Prediction of Preeclampsia in High-risk Pregnant Women: A Prospective Cohort Study

Introduction: Preeclampsia is one of the major complications of pregnancy, with an incidence of 1-35% worldwide. There is currently no reliable screening test to predict adverse complications of preeclampsia. In the non gravid uterus and early gravid uterus, uterine spiral vessels have high-resistan...

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Main Authors: Tomar Basar, Saumya Yadav, Noyomi Saring, Narang Yam, Taling Mari
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-08-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&volume=19&issue=8&page=QC09&issn=0973-709x&id=21414
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Summary:Introduction: Preeclampsia is one of the major complications of pregnancy, with an incidence of 1-35% worldwide. There is currently no reliable screening test to predict adverse complications of preeclampsia. In the non gravid uterus and early gravid uterus, uterine spiral vessels have high-resistance blood flow, which changes to low resistance during a normal pregnancy. However, this phenomenon fails to occur in preeclampsia, resulting in high flow impedance. Aim: To determine the occurrence of preeclampsia in high-risk pregnant women during the second trimester using the Pulsatility Index (PI) of the uterine and ophthalmic arteries. Materials and Methods: A prospective cohort study was conducted at the tertiary care centre (TRIHMS) in Arunachal Pradesh within the Department of Obstetrics and Gynaecology from November 2022 to October 2024. Patients (n=100) in the second trimester of pregnancy, who had risk factors for developing preeclampsia, were enrolled in the study. The PI of the uterine artery and ophthalmic artery was obtained using a curvilinear and linear probe, respectively. Patients were then followed-up for the development of preeclampsia from the time of enrollment in the study until discharge from the hospital after delivery of the baby. Statistical analyses were performed using the Chi-square test, Student’s t-test and Analysis of Variance (ANOVA). Results: The age of participants ranged from 18 to 44 years, with a mean age of 26±5.01 years. The mean±SD of participants’ weight, height, and Body Mass Index (BMI) were 66.37±7.99 Kg, 152.5±4.72 centimeters, and 28.48±6.35 kg/m2, respectively. A total of 27 participants developed preeclampsia during the course of this study. The sensitivity of the uterine artery PI was found to be 25% and specificity was 87% at a cut-off value of ≥1.45. The ophthalmic artery PI had a sensitivity of 85% and specificity of 58% at a cut-off value of <1.76. The current study summarised that the ophthalmic artery Doppler has a higher Negative Predictive Value (NPV) (91%), while the uterine artery Doppler has higher specificity (87%) in detecting preeclampsia. Conclusion: Doppler flow velocimetry is a non invasive and less time-consuming method of screening high-risk pregnancies, which can be made widely available. In cases where this screening test yields abnormal results in the second trimester, increased surveillance, timely follow-up and delivery in a well-equipped centre are essential to prevent or resolve maternal and foetal complications.
ISSN:2249-782X
0973-709X