Assessment of Late and Postterm Pregnancies using Doppler ultrasound

Abstract

This was prospective study carried out in -Khartoum state –Sudan, Khartoum Bahri Teaching hospital in the period from august 2016 to December 2018. The problem of study was the management of late-term and post term pregnancy creates a challenge to clinicians on the other hand the Doppler ultrasound can be used as an excellent tools to aid in management. The main aim of the study was to assess late-term and post term pregnancies by spectral Doppler ultrasound. The study was done in 197 pregnant women with normal singleton pregnancy with mean age 28 years, with gestational age by Last Menstrual period (GA LMP) 33-46 weeks and no maternal medical condition that may affect pregnancy outcome such as diabetic and hypertension. The data was collected by data collection sheet designed especially for this study and including all variables; then analyzed by statistical package for social sciences (SPSS). The study found that most of them were nulliparous (78.8%), most of fetus was cephalic presentation (94%), (49.7%) with GA of (33-38w6d) , ( 17.8%) term with GA of ( 39-40) weeks and postdate was ( 32.5%). The study found that there no significant difference in Doppler indices of UA in these three group of gestational age (p > 0.05), except for S\d ratio and PI which shows significant difference in different age group (p< 0.05), UA S\D ratio VII had significant weak negative correlation with GA (p <0.05) and UA PI,RI had no significant correlation with GA LMP ( p>0.05) and PSV and EDV shows positive significant weak correlation with GA LMP but in generally decreased by GA , Concerning linearity the study clarified that as GA increased Doppler indices of UA decreased RI, PI, S\D ratio and MCA increased PI decreased S\D ratio and RI remain constant .The study found that no significant difference in Doppler indices of MCA in these three group of gestational age. The study found that MCA PSV and EDV shows positive significant weak correlation with GA LMP (p< 0.05) , while PI and S\D ratio shows negative weak correlation with GA ,the mean MCA \ UA ratio was 1.87±1.31. There is significant relation between GA and adverse outcome as prevalence of oligohydramnios, macrosomia and cesarean section increased in postdate pregnancy. The study confirmed that no significant differences in all these Doppler indices in patients post term with adverse versus post term with normal outcome. The study concluded that Doppler indices in advance gestation and post term decreased with gestational age and increased in post term pregnancy with adverse outcome than in normal outcome but all were not significant. The study recommended that further studies with larger sampling of postdate to predict ratio for cases of adverse outcome in postdate pregnancy.