A Comparison of Changes in the Mean Arterial Blood Pressure and Mean Uterine Artery Pulsatility Index from 11-14 to 19-24 + 6 Gestation Weeks in Low-Risk and High-Risk Asian Indian Pregnant Women

Akanksha Baghel; Tejashree Y Patekar; Rijo M Choorakuttil; Lalit K Sharma; Shilpa R Satarkar; Anjali Gupta; Kavita Aneja; Sandhya Dhankhar; Gulab Chhajer; Somya Dwivedi; Mansi Jain; Srinivas Shentar; Praveen K Nirmalan

doi:10.1055/s-0043-1761250

A Comparison of Changes in the Mean Arterial Blood Pressure and Mean Uterine Artery Pulsatility Index from 11-14 to 19-24 + 6 Gestation Weeks in Low-Risk and High-Risk Asian Indian Pregnant Women

Indian J Radiol Imaging. 2023 Jan 31;33(2):195-200. doi: 10.1055/s-0043-1761250. eCollection 2023 Apr.

Authors

Affiliations

¹ Department of Clinical Radiology, Baghel Sonography Center, Harda, Madhya Pradesh, India.
² Department of Clinical Radiology, Innovision Sonography and Imaging Center, Gangapur, Nashik, Maharashtra, India.
³ Department of Clinical Radiology, AMMA Center for Diagnosis and Preventive Medicine Pvt Ltd, Kochi, Kerala, India.
⁴ Department of Clinical Radiology, Raj Sonography & X-Ray Clinic, Guna, Madhya Pradesh, India.
⁵ Department of Clinical Radiology, Antarang Sonography and Colour Doppler Center, Satarkar Hospital, Tilaknagar, Aurangabad, Maharashtra, India.
⁶ Department of Clinical Radiology, Anjali Ultrasound and Colour Doppler Centre, Shanti Madhuban Plaza, Delhi Gate, Agra, Uttar Pradesh, India.
⁷ Department of Clinical Radiology, Images Ultrasound Center, Naveda Healthcare Centre, Rohini, New Delhi, India.
⁸ Department of Clinical Radiology, Faith Diagnostic Center, Chandigarh, India.
⁹ Department of Clinical Radiology, Kushal Imaging & Diagnostic Center, Pali, Rajasthan, India.
¹⁰ Department of Clinical Radiology, Qura Diagnostics & Research Center, Janki Nagar, Kolar Road, Bhopal, Madhya Pradesh, India.
¹¹ Department of Clinical Radiology, IRIS Imaging Centre, Shahpura, Bhopal, Madhya Pradesh, India.
¹² Department of Clinical Radiology, Delta Diagnostic Services, Bengaluru, Karnataka, India.
¹³ Department of Research, AMMA Healthcare Research Gurukul, AMMA Center for Diagnosis and Preventive Medicine Pvt Ltd, Kochi, Kerala, India.

Abstract

Aim The aim of this study was to determine the changes in the mean arterial blood pressure (MAP) and mean uterine artery (UtA) pulsatility index (PI) from 11-14 to 19-24 + 6 gestation weeks in Asian Indian pregnant women. Methods Clinical and demographic details, MAP, and mean UtA PI measures were ascertained for pregnant women at 11 to 14 gestation weeks and 19-24 + 6 gestation weeks. Women were categorized as a high-or-low risk for preterm preeclampsia using the Fetal Medicine Foundation algorithm and 1 in 150 cutoff. High-risk pregnant women were recommended low-dose aspirin 150 mg daily at bedtime. Changes in MAP and mean UtA PI were compared for gestational age intervals and high-and-low risk women using nonparametric tests. Results The study analyzed the results of 1,163 pregnant women. Both MAP (mean difference: 5.14, p < 0.001) and mean UtA PI (mean difference: 0.14, p < 0.001) remained significantly higher at the second-trimester assessment in high-risk pregnant women compared to low-risk pregnant women. Seventy-seven (35.16%) of the 219 pregnant women with abnormal mean UtA PI in the first trimester had an abnormal mean UtA PI in the second-trimester assessment. One hundred (10.59%) of the 944 pregnant women with normal mean UtA PI in the first trimester had an abnormal mean UtA PI in the 19-24 + 6 weeks assessment. Seventy-seven pregnant women (6.62% of 1,163 women, 95% confidence interval: 5.33, 8.20) had an abnormal mean UtA PI at both gestation age intervals. High-risk pregnant women taking low-dose aspirin daily showed a larger reduction in mean UtA PI compared to high-risk pregnant women that did not report the use of low-dose aspirin (0.89 vs. 0.62, p <0.001) Conclusion MAP and mean UtA PI decreased significantly from the first to the second trimester of pregnancy. Sequential assessment of the MAP and mean UtA PI in the first and second trimesters of pregnancy will be useful for fetal radiologists in India to identify a subgroup of women with abnormal mean UtA PI at both trimesters that may need more intense surveillance and follow-up till childbirth.

Keywords: Doppler ultrasonography; fetal ultrasonography; mean arterial blood pressure; mean uterine artery pulsatility index; pregnancy.

Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).