FETAL DOPPLER VERSUS NST AS PREDICTOR OF ADVERSE PERINATAL OUTCOME IN SEVERE PIH AND IUGR.

Khwairakpam Robindro, Mitali Khatri, Mayanglambam Ronita Devi

Abstract


Background:  A healthy mother and a healthy baby has been the prime objective of prenatal care since time immemorial. This has gained great importance in recent times. Hypertensive disorders during pregnancy is the most common medical complication about 7% of all primigravidas and a very common cause of IUGR. The doppler flow velocimetry is the only means by which we can study the pathological changes in the placental bed before the clinical manifestations. NST describe fetal heart rate acceleration in response to fetal movement as a sign of fetal health. This study was undertaken to observe the doppler flow velocity in the umbilical artery compared with NST to predict perinatal outcome in high risk pregnancies.

 Materials and method: This open, prospective, randomized case control study was conducted on patients in the Department of Obstetrics and Gynaecology JNIMS, Imphal on 100 patients between September 2017 to August 2019.

Results:  In the group with abnormal NST but normal velocimetry, there were more women underlying caesarean delivery for fetal distress Those with normal NST had 50% caesarean rate and 40% required NICU admission, fetuses with abnormal velocimetry who also had a non-reactive NST are more susceptible to adverse outcome. Adverse perinatal outcome defined as fetal distress, CS for fetal distress, admission to NICU. The group having one abnormal test (doppler or NST) was not statistically significant, when both tests were abnormal, the outcome was statistically worse than the preceding three groups (P valve <0.001)

Conclusion: The sensitivity of NST was only 25% compared to 71.42% by doppler study whereas the specificity of the two modalities was comparable 93.75% and 88.13% respectively Our study clearly indicates that abnormal doppler findings in umbilical artery is a reflection of unfavorable outcome to fetal mortality and morbidity as compared to NST. As far as perinatal outcome is concerned it was more specifically observed in doppler study than NST study and a very reliable diagnostic modality in picking up cases at risk of adverse perinatal outcome.

Keywords


Doppler Velocimetry, Nst, Pih And Iugr Patients.

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