Insulin resistance and uterine artery Doppler as predictors of pregnancy induced hypertension

El Makawy, Al Shaimaa; El Kafrawy, Mona A; Abd El Hakeem, Samia F

doi:10.21608/jram.2020.40646.1079

Insulin resistance and uterine artery Doppler as predictors of pregnancy induced hypertension

Document Type : Original Article

Authors

¹ Obstetrics and Gynecology Department, Motobas Central Hospital, Kafer El-Sheikh, Egypt.

² Obstetrics and Gynecology Department, Faculty of Medicine for Girls, Cairo, Al-Azhar University, Egypt.

10.21608/jram.2020.40646.1079

Abstract

ABSTRACT
Background: In second trimester, pregnant women with pregnancy induced hypertension (PIH) have different indices of uterine artery doppler and different value of insulin resistance (IR) than normal pregnant women.
Objective: To ascertain the role of uterine artery doppler ultrasound and insulin resistance ratio in prediction of PIH
Methodology: The present cohort study was done on 211 women during pregnancy in the period between 18-28wk, and the pregnant were followed until delivery. They were coming for antenatal care in the obstetric outpatient clinic at Al-Zahra University Hospital from January 2016 to December 2018.
Results: In the current study, the mean age, body mass index (BMI), gestational age, systolic blood pressure (SBP) and diastolic blood pressure (DBP) among the studied group were 30.24 years, 25.08 kg/m², 22.40 wks,106.7mmHg, 69.12mmHg, respectively. 9.5% of the studied group were hypertensive, 5.7% mild PIH and 3.4% severe PIH. There were statistically significant differences of uterine artery Doppler indices between normotensive and PIH groups and between IR and PIH groups. Cutoff value of IR as a predictor for PIH patients is 1.2 with 70% sensitivity and 70% specificity in the current study. Also, among the severe hypertensive patients 42.8% had a diastolic notch, 28.5% had a reversed diastolic flow and 28.5% had an absent diastolic flow.
Conclusion: IR was a good predictor for PIH. There was a statistically significant difference between IR and PIH groups. Abnormal uterine artery doppler had a higher rate of detection of maternal and fetal complications. Uterine artery doppler is a good diagnostic test for development of preeclampsia.

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