Maternal Risk Factors and Ultrasound Doppler Indices in Pre-Eclampsia: A Comparative Study
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Background: Pre-eclampsia is a pregnancy-specific hypertensive disorder associated with maternal and foetal morbidity, and Doppler ultrasonography may support assessment of uteroplacental and fetoplacental haemodynamics. Objective: To compare maternal risk factors and ultrasound Doppler indices among pregnant women with and without pre-eclampsia and assess the diagnostic performance of Doppler parameters. Methods: This comparative cross-sectional study included 79 pregnant women beyond 20 weeks of gestation in a tertiary-care obstetrics and gynecology setting. Maternal clinical variables, proteinuria, blood pressure, and uterine and umbilical artery Doppler indices were recorded. Associations were assessed using chi-square testing, correlation analysis, and receiver operating characteristic analysis, with p < 0.05 considered statistically significant. Results: The mean age was 29.77 ± 6.49 years and mean gestational age was 29.13 ± 5.58 weeks. Pre-eclampsia was diagnosed in 71 participants (89.9%). Proteinuria was significantly associated with diagnosis (χ² = 7.452, p = 0.006). Systolic blood pressure correlated weakly with umbilical artery pulsatility index (r = 0.284, p = 0.011), while diastolic blood pressure correlated negatively with uterine artery resistive index (r = −0.266, p = 0.018). Umbilical artery resistive index showed the highest Doppler discrimination (AUC = 0.663). Conclusion: Doppler indices showed limited standalone diagnostic accuracy, but umbilical artery resistive index may provide supportive haemodynamic information when interpreted with blood pressure and proteinuria
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1. English FA, Kenny LC, McCarthy FP. Risk factors and effective management of preeclampsia. Integr Blood Press Control. 2015;8:7-12.
2. Ødegård RA, Vatten LJ, Nilsen ST, Salvesen KÅ, Austgulen R. Risk factors and clinical manifestations of pre-eclampsia. BJOG. 2000;107(11):1410-1416.
3. Kashanian M, Baradaran HR, Bahasadri S, Alimohammadi R. Risk factors for pre-eclampsia: a study in Iran. Arch Iran Med. 2011;14(6):412-415.
4. Anorlu RI, Iwuala NC, Odum CU. Risk factors for pre-eclampsia in Lagos, Nigeria. Aust N Z J Obstet Gynaecol. 2005;45(4):278-282.
5. Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):1-7.
6. Meler E, Figueras F, Mula R, Crispi F, Benassar M, Gómez O, Gratacós E. Prognostic role of uterine artery Doppler in patients with preeclampsia. Fetal Diagn Ther. 2010;27(1):8-13.
7. Lopez-Mendez MA, Martinez-Gaytan V, Cortes-Flores R, Ramos-Gonzalez RM, Ochoa-Torres MA, Garza-Veloz I, et al. Doppler ultrasound evaluation in preeclampsia. BMC Res Notes. 2013;6:477.
8. Razavi M, Rashidi Fakari F, Jafari FS, Farzaneh F, Sargolzaei N. The role of uterine artery Doppler ultrasound in the second trimester in predicting preeclampsia. Int J Pediatr. 2019;7(5):9405-9411.
9. Shahid N, Masood M, Bano Z, Naz U, Hussain SF, Anwar A, Hashmi AA. Role of uterine artery Doppler ultrasound in predicting pre-eclampsia in high-risk women. Cureus. 2021;13(7):e16276.
10. Myatt L, Clifton RG, Roberts JM, Spong CY, Hauth JC, Varner MW, et al. The utility of uterine artery Doppler velocimetry in prediction of preeclampsia in a low-risk population. Obstet Gynecol. 2012;120(4):815-822.
11. Adekanmi AJ, Roberts A, Akinmoladun JA, Adeyinka AO. Uterine and umbilical artery Doppler in women with pre-eclampsia and their pregnancy outcomes. Niger Postgrad Med J. 2019;26(2):106-112.
12. Rose S, Farooq SMY, Fatima M, Gilani SA, Rana AS, Ramzan I. Correlation between fetal umbilical artery and middle cerebral artery Doppler indices in preeclamptic and normotensive pregnancies. J Diagn Med Sonogr. 2024;40(4):352-359.
13. Ødegård RA, Vatten LJ, Nilsen ST, Salvesen KÅ, Austgulen R. Preeclampsia and fetal growth. Obstet Gynecol. 2000;96(6):950-955.
14. Borman J, Nath KK, Majumdar M, Boro RC. Evaluation of uterine artery Doppler mean pulsatility index at 11-14 weeks of gestation in primigravida women of singleton pregnancy as a predictor of preeclampsia: a prospective cohort study. Eur J Cardiovasc Med. 2025;15(11).
15. Liu Y, Xie Z, Huang Y, Lu X, Yin F. Uterine arteries pulsatility index by Doppler ultrasound in the prediction of preeclampsia: an updated systematic review and meta-analysis. Arch Gynecol Obstet. 2024;309(2):427-437.
16. Martin-Alonso R, Prieto P, Fernández-Buhigas I, German-Fernandez C, Aramburu C, Piqueras V, et al. Association between perinatal outcomes and maternal risk factors: a cohort study. Medicina. 2024;60(7):1071.
17. Chantanahom N, Phupong V. Clinical risk factors for preeclampsia in twin pregnancies. PLoS One. 2021;16(4):e0249555.
18. Turbeville HR, Sasser JM. Preeclampsia beyond pregnancy: long-term consequences for mother and child. Am J Physiol Renal Physiol. 2020;318(6):F1315-F1326.
19. Mönckeberg M, Arias V, Fuenzalida R, Álvarez S, Toro V, Calvo A, et al. Diagnostic performance of first trimester screening of preeclampsia based on uterine artery pulsatility index and maternal risk factors in routine clinical use. Diagnostics. 2020;10(4):182.
20. Shiozaki A, Saito S. Risk factors for preeclampsia. In: Preeclampsia: Basic, Genomic, and Clinical. Singapore: Springer; 2018. p. 3-25.
21. Rani S, Huria A, Kaur R. Prediction of perinatal outcome in preeclampsia using middle cerebral artery and umbilical artery pulsatility and resistance indices. Hypertens Pregnancy. 2016;35(2):210-216.
22. Hannaford KE, Tuuli M, Goetzinger KR, Odibo L, Cahill AG, Macones G, Odibo AO. First-trimester 3-dimensional power Doppler placental vascularization indices from the whole placenta versus the placental bed to predict preeclampsia: does pregnancy-associated plasma protein A or uterine artery Doppler sonography help? J Ultrasound Med. 2015;34(6):965-970.
23. Martínez-Ruiz A, Sarabia-Meseguer MD, Vílchez JA, Pérez-Fornieles J, Delgado-Marín JL, Tovar-Zapata I, Noguera-Velasco JA. Second trimester angiotensin-converting enzyme and uterine artery Doppler as predictors of preeclampsia in a high-risk population.
24. Li L, Zheng Y, Zhu Y, Li J. Serum biomarkers combined with uterine artery Doppler in prediction of preeclampsia. Exp Ther Med. 2016;12(4):2515-2520.
25. Puttapitakpong P, Phupong V. Combination of serum angiopoietin-2 and uterine artery Doppler for prediction of preeclampsia. Hypertens Res. 2016;39(2):95-99.
26. Gomez-Roig MD, Mazarico E, Sabria J, Parra J, Oton L, Vela A. Use of placental growth factor and uterine artery Doppler pulsatility index in pregnancies involving intrauterine fetal growth restriction or preeclampsia to predict perinatal outcomes. Gynecol Obstet Invest. 2015;80(2):99-105.
27. Polat I, Gedikbasi A, Kiyak H, Gulac B, Atis A, Goynumer G, Dundar O, Ark C. Double notches: association of uterine artery notch forms with pregnancy outcome and severity of preeclampsia. Hypertens Pregnancy. 2015;34(1):90-101.