Perinatal outcome prediction in patients with Preeclampsia using fetaldoppler studies at Moi Teaching and Referral Hospital

Abstract

Background: Preeclampsia is a major direct cause of maternal mortality second only to hemorrhage with 50,000-60,000 preeclampsia related deaths worldwide annually. In the fetus, it can lead to ischemic encephalopathy, growth restriction and the various sequelae of premature birth. Pregnancies complicated by preeclampsia require close fetal surveillance to guide management and improve outcomes. Objective: To determine the fetal Doppler indices of the umbilical and middle cerebral arteries in the prediction of perinatal outcomes in patients with preeclampsia. Methods:A cross sectional study done at theMoi Teaching and Referral Hospital.Consenting patients with preeclampsia above 28 weeks gestation were consecutively sampled. A total of 165 patients were studied.Descriptive statistics were carried out. Inferential statistics was also carried out. Results:Majority (72.7%) presented between 28-34 weeks and 66.06% had preeclampsia.An abnormal outcome was seen in 80% of those who had abnormal Doppler findings which increased the Odds of poor outcome 11.5 times (p<0.001). Poor perinatal outcomes included still birth, preterm birth, low birth weight and low APGAR score. MCA RI had no significant association with poor outcomes except when used as Cerebro-Placental Index (CPI). Conclusion: Majorityhad abnormal Doppler findings.Abnormal Doppler findings were significantly associated with poor perinatal outcomes.