DOI: 10.36347/sjams.2018.v06i09.049

Pages: 3496-3500

Preeclampsia is a preventable cause of maternal mortality and should be detected and appropriately managed before the onset of convulsions (eclampsia) and other life-threatening complications. To assess the role of Uterine artery Doppler and Maternal serum pregnancy associated plasma protein-A (PAPP-A) at 11-14 weeks of gestation in prediction of preeclampsia. Seventy eight pregnant women with 11- 14 weeks of gestation were studied at the Department of Obstetrics and Gynaecology, King George Medical University, Lucknow from September 2014 to August 2015. The women who developed preeclampsia and related complications at the end of pregnancy were grouped under GROUP 1 (n=29) and the women who did not develop any of these complications were kept under GROUP 2 (n=49). After routine antenatal examination uterine artery doppler and PAPP-A were measured in each patients. The mean pulsatility index (PI) multiple of the median (MoM) of the women who developed preeclampsia and related complications was 1.18 ± 0.317and that of women who did not develop complications was 0.90 ± 0.316 (p = 0.003). The relative risk of development of complications in women with presence of ‘notching’ was 2.48 (95% CI = 1.479 – 4.159, p = 0.004). The relative risk of development of preeclampsia in the presence of notch was 2.48 (95% CI = 0.742 to 0.832, p = 0.28) but this was not statistically significant. The relative risk of development of IUGR in women with notch in uterine artery Doppler at 11-14 weeks of pregnancy is 2.22 (95% CI = 1.187-4.146, p= 0.037).The mean PAPP-A MoM of women who developed preeclampsia, early onset preeclampsia, late onset preeclampsia, IUGR was 4.97 ± 3.89 (p = 0.179), 5.77 ± 4.61 (p = 0.061), 3.39 ± 1.12 (p = 0.76) and 4.30 ± 3.70 (p = 0.43) respectively. Uterine artery Doppler pulsatility index (PI) alone is the best screening method at 11-14 weeks of gestation for women at high risk of preeclampsia and related complications.