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Hemodynamic changes in uteroplacental vasculature in pregnancy-induced hypertension and its effect on pregnancy outcome

Shikha Gupta, Varad Gupta, Shriya Gupta, Tayal B B.


Abstract

Background: Among the various complications of pregnancy, pregnancy-induced hypertension is found to be the most common which may affect maternal and fetal outcome. The most common being retarded growth of fetus in utero.

Aim and Objective: This study aims to assess hemodynamic variations in uteroplacental circulation in pregnancy-induced hypertension and its effect on fetal outcome.

Materials and Methods: Subjects were divided into two groups as Group A of 50 subjects of normal pregnancy (controls) and Group B of 50 subjects of pregnancy-induced hypertension (cases) all in the age group of 25–34 years and having 28–32 weeks of gestation. Blood pressure was recorded and fetal biometry was done ultrasonologically to find average gestational age and effective fetal weight. Pulsatility index, resistive index, and systolic-diastolic ratio in bilateral uterine, umbilical, and middle cerebral arteries were recorded using color Doppler. Mean and standard deviation was calculated for all values of Doppler indices in both groups and Student’s t-test (unpaired) was used. P < 0.05 was considered statistically significant.

Results: All three taken Doppler indices showed a decreasing trend in both groups but decrease was less in pregnancy-induced hypertensives as compared to that in normal pregnancy for same gestational age suggesting higher resistance to blood flow in fetoplacental circulation in gestational hypertension. Small for gestational age fetuses were seen in 10 out of 50 cases. Normal for gestational age fetuses were seen in controls.

Conclusion: Pregnancy-induced hypertension causes hemodynamic variations in uteroplacental vasculature which may be responsible for causing impaired fetal growth in some cases.

Key words: Pregnancy-Induced Hypertension; Uteroplacental Circulation; Fetal Growth






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