A Prospective Observational Study of Correlation of Ductus Venosus Doppler and Fetal Outcome in Preeclampsia.

Background

Preeclampsia is a major contributor to maternal and perinatal morbidity and mortality worldwide. Abnormal placentation and uteroplacental insufficiency result in fetal hypoxia and hemodynamic redistribution. While arterial Doppler parameters are widely used, ductus venosus (DV) Doppler may detect early fetal cardiac compromise.

Objective

To evaluate the correlation between DV Doppler findings and fetal outcomes in preeclampsia.

Materials And Methods

This prospective observational study included 78 women with preeclampsia between 34 and 40 weeks of gestation. DV Doppler assessment included pulsatility index and a-wave morphology. Abnormal DV was defined as PI >95th percentile or absent/reversed a-wave. Participants were followed until delivery. Maternal and neonatal outcomes were analyzed.

Results

Abnormal DV Doppler was observed in 16.6% of cases and showed a strong association with abnormal cerebroplacental ratio (P < 0.001). Preterm delivery increased progressively from 13.8% in normal a-wave to 77.8% in flat and 100% in reversal patterns (P = 0.041). Low Apgar scores at 1 min were significantly higher in abnormal DV groups (66.7% flat; 50.0% reversal; P = 0.009). Neonatal intensive care unit admission was more frequent in flat (66.7%) and reversal (50.0%) groups compared to normal DV (15.4%) (P = 0.002). Low birth weight was universal in abnormal DV cases (P = 0.031), and fetal demise occurred exclusively in the reversal a-wave group (50.0%; P = 0.011).

Conclusion

Abnormal DV Doppler waveforms are strongly associated with adverse perinatal outcomes in preeclampsia. Combined arterial and venous Doppler assessment provides a comprehensive evaluation of fetal compromise and may aid in optimizing the timing of delivery.