Contribution of the aortic isthmus blood flow index to Doppler ultrasound evaluation in preeclampsia

Abstract

In this study, BPP was normal in 14 patients (72%), and abnormal in 6 patients (28%). So, the conclusion of our study is that there are significant AI RI & UT RI changes in preeclamptic women which can predict early hemodynamic changes & affection of BPP and therefore can help in prevention of FGR. Also there was no significant agreement between AI Doppler indices & any other examined parameter so not all UT Doppler changes will cause AI Doppler changes as well as not all abnormal AI Doppler indices will be associated with abnormal MCA & AMB Doppler indices. The pathophysiology of PE is based on the incapability of the trophoblast to invade properly the myometrium causing a limited remodeling of spiral arteries. The impaired placental perfusion caused by vascular abnormalities precedes clinical manifestations of PE and it can be detected by Doppler ultrasound (US).Because no therapy at present has been shown to significantly improve placental function, the goal of prenatal testing in such cases is to detect early haemodynamic changes, enough to avoid the sequel of iatrogenic severe prematurity, yet early enough to avoid fetal death. Doppler ultrasonography and biophysical profile scoring (BPP) are the principal surveillance tools in pregnancies complicated by preeclampsia. These antenatal testing modalities aim to detect fetal compromise by evaluating fetal manifestations of altered oxygenation and metabolic status. Fetal cardiovascular responses are a prominent feature of this form of growth restriction and their assessment reflects disease severity. As placental blood flow resistance worsens, changes in descending aortic and cerebral blood flow resistance are observed in the compensated state.