Abstract
Objectives: To Compare The Efficacy Of Doppler Technique Over Nonstress Test (Nst) In Predicting Fetal Compromise In Utero In Cases Of Pre Eclampsia Pregnancies And Feto Maternal Outcome.
Method: A Total Of 100 Third Trimester Pregnant Patients Hospitalized As Pre Eclampsia Cases,Were Examined Prospectively And Serially Color Doppler And Nst.
After Admission, The Patients Underwent Routine Antenatal Surveillance Including External Ultrasound Cardiotocography Recordings Performed As Nst For 20 Min Daily Or Sometimes Twice Daily.. The Umbilical Cord Was Insonated By Doppler Ultrasound Beam Directed Towards The Fetal Abdomen, The Fetal Vessels Were Located In The Standard Plane And Doppler Evaluated Regards To Pulsatility Index; Cerebroplacental Ratio And Absence Or Reversal Of Flow.
For Analysis Of The Results, The Patients Were Grouped According To Findings At The Cardiotocography And Doppler Flow Examinations: Group A Had Normal Nst And Normal Flow Velocity
Group B Had Abnormal Nst (Suspect, Slight Or Severe Pathological Nst), At One Or More Occasions And Normal Flow Velocity Waveform Group C Had Normal Nst And Abnormal Flow Velocity Waveform At One Or More Occasions Group D Had Both Abnormal Nst And Flow Velocity Waveform
The Chi Square Test Was Used For Statistical Analysis Of The Data With Continuity Correction As Appropriate, A P Value <0.05 Being Considered Significant.
Odds Ratio And Confidence Interval Were Calculated In Comparative Groups
Results: Fetal Doppler Has The Power To Discriminate Between Sick And Healthy Fetuses And With Serial Measurements It Is Possible To Monitor Any Deterioration In The Fetus. In Chronic Hypoxia Doppler Changes Occur First While Abnormal Fetal Heart Tracings Represent Late Signs Of Fetal Deterioration.Though Both Test Results Were Effective In Predicting Abnormal Outcome, The Significant Advantage Of Doppler Over Nst Observed In Our Study In Group D Was That Doppler Showed Changes Earlier Than Nst Giving A Significant Lead Time Of Up To 9 Days With An Average Of 4.14 Days.
Conclusion: Doppler Is Useful In Recognizing Fetal Compromise Earlier Than Nonstress Test Giving A Lead Time Which Is Important In The Management Of Pre Eclampsia Pregnancies.Combined Fetal Testing Modalities Such As Doppler, Nst And Biophysical Profile Provide A Wealth Of Information Regarding Fetal Health. Integrated Fetal Testing Would Be Ideal For Individualized Care Of The Preterm Compromised Fetus For Timed Intervention.