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The sensitivity of Doppler studies vs. biochemical indices in predicting fetal outcome in cases of pregnancy induced hypertension
Author(s) -
Ghoneim M. R.,
Nicolaides K.,
Moneim M. A. AbdEl,
Megahid H. E.,
Hafez M. S.
Publication year - 2001
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2001.abs27-17.x
Subject(s) - medicine , pregnancy , obstetrics and gynaecology , obstetrics , gestational hypertension , preeclampsia , gestational age , fetus , umbilical artery , outpatient clinic , genetics , biology
Location: The Outpatient Clinic of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt and the High Risk Pregnancy Unit of King's College University Hospital, London, UK. Aim of the work: To compare the sensitivity and specificity of the Doppler studies vs. the biochemical indices in predicting fetal outcome in cases of pregnancy induced hypertension. Material and methods: A total of 252 cases were the subject of this study 192 cases from King's College Hospital and 60 from Suez Canal University Hospital. All cases were selected as having pregnancy‐induced hypertension, 226 cases with proteinuric hypertension and 26 cases with non‐proteinuric pregnancy induced hypertension. All cases were monitored weekly from 28th gestational week till delivery whereby all Doppler studies were carried out on a free loop of umbilical artery. Serum uric acid, liver enzyme aspartate‐aminotransferase, and platelet count were estimated weekly. Results: Out of 252 patients with PIH, 136 patients (54%) had abnormal Doppler flow velocimetry associated with abnormal higher mean AST proteinuria, serum urate >350 mm/L, lower platelet count and higher perinatal mortality. The sensitivity and specificity of abnormal Doppler velocimetry in the prediction of intrauterine growth retardation (IUGR) were 80 and 52.6%. These were raised to 94 and 88%, respectively, with higher mean serum urate and lower platelet counts. However, the specificity of the abnormal Doppler with abnormal all biochemical indices for the prediction of adverse neonatal outcome and IUGR was 100%, but this was a late event in cases of PIH as the sensitivity dropped down. It is not advisable to wait for both to happen before taking a decision for induction of labor.