Abnormal umbilical artery Doppler in third trimester and perinatal outcome: a retrospective study

Background: Umbilical artery Doppler (UAD) has the greatest impact in modern obstetric assessment in high risk pregnancies. The objective of this study was to evaluate the maternal characteristics and perinatal outcome in pregnancies complicated by abnormal umbilical artery Doppler. Methods: A retrospective study was designed to analyze the medical records of 50 singleton pregnant women who delivered in the labour ward of our institution from 1 st July 2014 to 30 th June 2015. The study population had abnormal umbilical artery Doppler velocimetry with varying degree of reduction in placental circulation. These patients were assessed for maternal complications and foetal outcome. Results: Results of present study revealed that majority of women who had abnormal placental Doppler flow were under 37 weeks of gestation (82%). Absent end diastolic flow was seen more in pre-eclampsia/ eclampsia (38%), gestational diabetes (19%) and oligohydramnios (52%) as compared to high systolic/diastolic (S/D) ratio. Higher incidence of abruption (25%), operative deliveries (50%), intrauterine deaths (25%) and still births (25%) was seen with increase in the severity of placental insufficiency. High frequency of pre-maturity (76%) was noticed in this study as a result of abnormal Doppler. Neonatal complications like jaundice, RDS (Respiratory distress syndrome), IVH (Intra-ventricular haemorrhage) and NEC (Necrotizing enterocolitis) were recorded in increasing trends in present study. Conclusions: Umbilical artery Doppler helps in the prediction of possible maternal and foetal complications in cases of compromised placental flow. Monitoring of antenatal parameters, availability of emergency facility for early surgical intervention and neonatal care pave a long way in curtailing perinatal morbidity and mortality.