Study of doppler changes in pregnancy induced hypertension

Background: Pregnancy induced hypertension is a high risk pregnancy that threatens the health of the mother or her foetus. The recent introduction of colour Doppler flow imaging provides opportunity for non-invasive monitoring during pregnancy. Objective: The aim of present study was to know the significance of Doppler in pregnancy induced hypertension and to analyse their role in predicting perinatal outcome. Materials and Methods: It was a prospective study conducted amongst 180 women diagnosed with PIH from August 2018 to November 2019 in a general hospital which is a tertiary level referral centre having well equipped Neonatal Intensive Care Unit (NICU). All pregnant women diagnosed with PIH after 20 weeks of gestation were included in the study. Pulsatility Index (PI) in uterine, umbilical and middle cerebral artery were noted and end diastolic flow in umbilical artery doppler was also noted. Their perinatal outcome was noted. Results: It is observed that maximum number of pregnant women were in the age group of 20-24 years.144 patients suffering from PIH had mild disease whereas 36 patients had severe disease. 31 patients had diastolic notch in uterine artery. 33 patients had elevated umbilical artery PI while 147 patient had normal PI. 2 patients showed reversal and 28 patients showed absent end diastolic flow. 34 patients had decreased MCA PI while 146 patients had normal PI. 35 patients had abnormal MCA/Umbilical artery PI ratio whereas 145 patients had normal ratio. 41 had adverse perinatal outcome and 139 had uneventful outcome. 21 patients had elevated uterine artery PI as well as adverse perinatal outcome. 23 patients had uterine artery diastolic notch as well as adverse perinatal outcome. 29 patients had elevated umbilical artery PI as well as adverse perinatal outcome. 31 patients had decreased MCA PI as well as adverse perinatal outcome. 32 patients had MCA/Umbilical artery PI ratio less than 1.08 as well as adverse perinatal outcome. Conclusion: The knowledge of uterine, umbilical and middle cerebral artery waveform may help to improve pregnancy management and permit identification of pregnancy induced hypertension at earliest gestation age. Doppler plays an important role in monitoring growth restricted foetus and thereby may help to determine the optimal time for delivery.