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Title: The Uterine Artery Doppler's Diagnostic Accuracy in the Second Trimester for Preeclampsia Screening
Authors: Ayesha Arjmand, Ayesha Umer, Sajida Imran, Razia Ghafoor, Fouzia Ubaid, Khola Butt
Journal: Pakistan Journal of Medical Research (PJMR)
Publisher: Health Research Institute (HRI), NIH
Country: Pakistan
Year: 2024
Volume: 63
Issue: 3
Language: English
Keywords: PreeclampsiaUterine artery DopplerPulsatility indexResistance index
Background: Hypertension during pregnancy occurs in 7-10% of pregnancies. It is divided into 3 types: Chronic hypertension, pregnancy-induced hypertension, and Pre-eclampsia. It is a multisystem syndrome usually recognized by new-onset hypertension with proteinuria appearing in 2nd half of pregnancy. The incidence of preeclampsia is 5 to 7% of all pregnancies.
Objective: To determine the diagnostic accuracy of uterine artery Doppler (UAD) for preeclampsia screening in the second trimester.
Study type, settings & duration: A cross-sectional and observational study was conducted at Hameed Latif Hospital, Lahore from January to June 2023.
Methodology: The non-probability purposive sampling technique was used in this study. Patients were into two groups; Group A: Pre-eclampsia (n=40) and Group B: Non-Pre-eclampsia (n=85). The sample size of 125 was calculated by G-Power software. Data was collected through pre-structured proforma and entered in SPSS version 25.0.
Results: The 28 (70%) patients had positive UAD. They developed pre-eclampsia and 12 (30%) patients had negative but also developed pre-eclampsia (group A). In comparison, 15 (17.6%) patients had positive UAD but had not developed pre-eclampsia and 70 (82.4%) patients had negative UAD and had not developed pre-eclampsia. UAD and pre-eclampsia had a significant association with the p-value of 0.00*. Pre-eclampsia screening had a 15.5% margin of error, a 25% anticipated proportion of pre-eclampsia, a 75% UAD sensitivity, and an 86% specificity.
Conclusion: Doppler USG is accurate enough that in the future we can rely on this tool for the prediction of PE in primigravidas. So, to detect preeclampsia early...........
To determine the diagnostic accuracy of uterine artery doppler (UAD) for preeclampsia screening in the second trimester.
A cross-sectional and observational study was conducted at Hameed Latif Hospital, Lahore from January to June 2023. A non-probability purposive sampling technique was used. Patients were divided into two groups: pre-eclampsia (n=40) and non-pre-eclampsia (n=85). The sample size of 125 was calculated using G-Power software. Data was collected via a pre-structured proforma and analyzed using SPSS version 25.0.
graph TD;
A["Study Design: Cross-sectional, Observational"] --> B["Patient Recruitment: Hameed Latif Hospital, Jan-Jun 2023"];
B --> C["Sampling: Non-probability Purposive"];
C --> D["Group Allocation: Pre-eclampsia n=40, Non-pre-eclampsia n=85"];
D --> E["Data Collection: Pre-structured Proforma"];
E --> F["Data Analysis: SPSS v25.0"];
F --> G["Calculate Diagnostic Accuracy Sensitivity, Specificity"];
G --> H["Draw Conclusions"];
The study suggests that Doppler ultrasound is a valuable tool for assessing uteroplacental circulation and can aid in identifying high-risk pregnancies for pre-eclampsia. Abnormal Doppler findings, such as increased resistance index, persistent uterine artery notch, and elevated pulsatility index, are associated with pre-eclampsia. The authors advocate for the routine incorporation of second-trimester UAD for early detection and prevention of pre-eclampsia.
Uterine artery doppler (UAD) showed a significant association with pre-eclampsia (p-value of 0.00*). In the pre-eclampsia group, 28 (70%) patients had positive UAD. In the non-pre-eclampsia group, 70 (82.4%) patients had negative UAD. The study reported a 15.5% margin of error, a 25% anticipated proportion of pre-eclampsia, a 75% UAD sensitivity, and an 86% specificity for pre-eclampsia screening.
Doppler ultrasonography is accurate enough to be relied upon for the prediction of pre-eclampsia in primigravidas. Routine incorporation of second-trimester UAD is recommended for early detection of pre-eclampsia to prevent perinatal morbidity and mortality.
- Hypertension during pregnancy occurs in 7-10% of pregnancies. (Confirmed in Introduction)
- The incidence of preeclampsia is 5 to 7% of all pregnancies. (Confirmed in Introduction)
- A sample size of 125 was calculated by G-Power software. (Confirmed in Methodology)
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