title: Prediction of perinatal outcome in preeclampsia using middle cerebral artery and umbilical artery pulsatility and resistance indices.
abstract: OBJECTIVE
  In preeclampsia, changes in fetal hemodynamics can be detected 2-3 weeks earlier than any changes in cardiotocogram. Thus, these Doppler changes can be used to predict perinatal outcome. The present study is planned to assess the accuracy of the middle cerebral artery to umbilical artery (UA) pulsatility index (PI) and resistance index (RI) in predicting adverse perinatal outcome in pregnancies complicated by preeclampsia.
  
  
  METHODS
  Total of 115 and 108 pregnant women were included in preeclampsia and control group, respectively. Weekly Doppler study was done in both groups starting from 30 weeks till 36 weeks or delivery, whichever is later.
  
  
  RESULTS
  Mean gestational age at delivery was 250 ± 13 and 273 ± 8 days, respectively, in preeclampsia and control group (p < 0.01). Thirty-four babies in preeclampsia group had been admitted to nursery; out of which three died (p < 0.01). On receiver operating characteristic analysis, MCA /UmA PI ratio and MCA /UmA RI ratio had sensitivity of 9% and 9.7% and specificity of 98% and 96.6%, respectively, for predicting adverse perinatal outcome.
  
  
  CONCLUSIONS
  Doppler indices of MCA and Um A are significantly abnormal in preeclampsia. But on diagnostic statistical analysis they have good specificity but low sensitivity for detecting adverse perinatal outcome.
authors.affiliation: a Obstetrics and Gynaecology , Government Medical College & Hospital , Chandigarh , Chandigarh , India.
authors.forename: Shikha
authors.initials: S
authors.lastname: Rani
authors.affiliation: a Obstetrics and Gynaecology , Government Medical College & Hospital , Chandigarh , Chandigarh , India.
authors.forename: Anju
authors.initials: A
authors.lastname: Huria
authors.affiliation: a Obstetrics and Gynaecology , Government Medical College & Hospital , Chandigarh , Chandigarh , India.
authors.forename: Ravinder
authors.initials: R
authors.lastname: Kaur
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011379:Prognosis; D011673:Pulsatile Flow / Q000502:physiology*; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014655:Vascular Resistance / Q000502:physiology*; D055815:Young Adult
keywords: Doppler indices; middle cerebral artery; perinatal outcome; preeclampsia; umbilical artery