Severe Early– Onset Preeclampsia: Prognostic Role of Uterine Artery Doppler Examination

Abstract

ABSTRACT:BACKGROUND: Preeclampsia is essentially an endothelial disease. Early- onset preeclampsia appears to be linked mainly to a failed placental vascular remodeling. Uterine artery Doppler is a validated noninvasive surrogate of trophoblastic invasion and placental perfusion.OBJECTIVE: To evaluate the predictive capacity of uterine artery Doppler investigation for maternal and neonatal complications in women with severe early- onset preeclampsia.METHODS: This prospective comparative study was carried out on sixty-five Iraqi pregnant women with severe early-onset preeclampsia. Their gestational age ranged from 28-34 weeks of gestation. A uterine artery Doppler examination was performed on admission to the participants. According to the result of Doppler ultrasound, they were arranged into two main groups: group one comprising twenty-nine patients with normal uterine artery Doppler results, and group two comprising thirty-six patients with abnormal uterine artery Doppler results. The maternal and neonatal outcome of women with abnormal uterine Doppler results was compared to those with normal Doppler results, and then results were analyzed accordingly. RESULTS: Sixty-five patients were enrolled in this study. In 53% of them, uterine artery Doppler results were abnormal. This group showed statistically significant lower birth weight (p = 0.003), higher caesarean section rate (p= 0.014), abnormal umbilical artery Doppler examinations (p=0.0001) and higher neonatal complications rate (P= 0.006). Regarding the maternal complications (HELLP syndrome, neurological manifestations, acute renal failure and pulmonary oedema), occurred at higher rate in the group with abnormal uterine artery Doppler compared with those having normal Doppler results (58.3% versus 37.9%), but only acute renal failure reached the statistical level of significance (P=0.017). CONCLUSION: Women with severe early-onset preeclampsia are at higher risk of maternal and neonatal complications if abnormal uterine blood flow is present. .