Title: The Role of Ultrasound in the Assessment of Fetal Growth and Placental Maturation in Pregnancy Induced Hypertension
Authors: Alaa Eldin Mohamed Abd Elhameid, Tarek Abd Elzaher Karkour, Moataz Mohamed Montasser, Shimaa Mohamed Shaban
DOI: http://dx.doi.org/10.18535/jmscr/v3i11.45
Abstract
Aim:This study was undertaken to evaluate the role of grey scale and Doppler ultrasound in the assessment of fetal growth and placental maturation in pregnancy induced hypertension (PIH).
Methods:Forty pregnant female diagnosed as pregnancy induced hypertension were included. History taking, general and obstetric examination as well as laboratory investigation were done. The periodic follow up was included grey scale ultrasound (fetal biometry, placenta grade and liquor assessment) and Doppler ultrasound (umbilical artery, middle cerebral artery and fetal aorta blood flow). The perinatal outcome results included intrauterine growth retardation (IUGR), prematurity, intrauterine fetal death (IUFD) and early neonatal death were documented and correlated with the ultrasound findings.
Results: There was increased incidence of Grade III placenta in pregnant females with PIH as there were 40 %( n=16) had grade II placenta while 60 %( n=24) had grade III placenta. There was an association between grade III placenta and intrauterine growth retardation. All patients presented with IUGR (n=9) showed abnormal Doppler waveforms. Eight of them had abnormal MCA/UA ratio and only one expressed normal ratio. Increased number of vessels affection was associated with adverse pregnancy outcome as IUGR, prematurity, IUFD and early neonatal death. Umbilical artery Doppler with absent or reversed diastolic flow was ominous signs as both findings were associated with IUFD and neonatal death.
Conclusion: Fetal ultrasound has a valuable role in predicting adverse perinatal outcome associated with PIH. It has important role in assessment of placental maturation and its effect on fetal growth and placental dysfunction. Doppler imaging can significantly evaluate complication associated with PIH by providing valuable information about the hemodynamic state of the fetus.
Keywords: PIH, grey scale ultrasound, Doppler ultrasound, Umbilical artery, Middle cerebral artery, Cerebroplacental ratio, IUGR.
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