Role of uterine artery Doppler and roll over test in prediction of pregnancy induced hypertension

Abstract

Background: The objectives of the study were the role of uterine artery Doppler ultrasound and roll over test in prediction of PIH. Methods: After assessment of inclusion and exclusion criteria  54 antenatal women of 11-13 weeks of gestation selected for study in Department of Obstetrics and Gynecology of JSS Hospital, Mysore and are subjected to transabdominal ultrasound for dating scan and screening of uterine artery Doppler ultrasound at 11-13 weeks and again rescanned at 21-24 weeks for uterine artery Doppler ultrasound and further followed up for Roll Over Test at 28-32 weeks of gestation for development of gestational hypertension, preeclampsia and eclampsia. The presence of early diastolic notch, increased pulsatility index and resistance index are considered to be a positive predictor of preeclampsia. A positive Roll Over test is an elevation of 20 mm of Hg or more in diastolic pressure when the woman rolls over from lateral decubitus to the supine position. Results: The primary outcome was that uterine artery Doppler ultrasound alone and combined together with roll over test shows a high specificity of 96.29% for prediction of PIH than Roll over test alone (77.77%). Positive predictive value of uterine artery study (91.68%) was higher than Roll over Test alone (64.70%) and almost equal when both uterine artery and Roll over Test are taken together (91.66%). Conclusions: From this study we concluded that uterine artery Doppler in first and second trimester is a better predictor of PIH. Combination of Roll over test and uterine artery Doppler has similar predictive value as uterine artery Doppler than Roll over test alone.