Purpose: To study the fetoplacental and uteroplacental circulation by evaluating uterine artery, umbilical artery and fetal MCA using color Doppler in hypertensive disorders of pregnancy and oligohydramnios in second and third trimester with comparing different parameters.
Methodology: Total 62 antenatal patients in their second or third trimester, who were clinically diagnosed as having pregnancy-induced hypertension or oligohydramnios by department of obstetrics had been recruited. Color Doppler study of umbilical artery, uterine artery and fetal MCA was performed with measurement of umbilical artery PI and SV/DV ratio, MCA PI and SV/DV ratio, uterine artery RI and SV/DV ratio and CPR.At last, color Doppler prediction was correlated with fetal outcome.
Results: Out of 62 patients, 27 had PIH, 14 had associated oligohydramnios with PIH and 21 had oligohydramnios. 56% patients with PIH and 47% patients with oligohydramnios had adverse fetal outcome. The percentages of abnormal parameters of uterine artery, umbilical artery and MCA in PIH patients were 61%, 46% and 51% respectively. The sensitivity and specificity for detecting fetal distress was 70% and 81%, 70% and 87% and 67% and 86% for uterine artery, umbilical artery and fetal MCA respectively. CPR was 100% sensitive and 92.3% specific in detecting severe fetal distress.
Conclusion: Chances of fetal compromise inutero are high in PIH patients, also significant number of oligohydramnios patients show adverse fetal outcome. Color Doppler study of fetoplacental and uteroplacental circulation proved a useful and noninvasive technique in determining hypoxic fetus and planning timely management of delivery before severe hypoxic injury to fetus occurs. Uterine artery and umbilical artery are more sensitive followed by MCA in diagnosing fetal distress.