Comparison of Pulsatility Index and Notching of Uterine Artery Doppler on Normotensive Pregnancy and Established Pre-eclampsia

Abstract

Objective: The aim is to assess the pulsatility index of the uterine artery (UtA-PI) and the presence of notching, then compare them between normotensive pregnancy and pre-eclampsia. Methods: This cross-sectional study was conducted at dr. Sardjito Hospital and Harapan Kita Maternal Children Hospital as a tertiary referral hospital. The study involved 220 women, this includes pregnant women who are at risk of illness and mortality during pregnancy, parturition, and postpartum periods, specifically those with chronic hypertension and a history of pre-eclampsia. The inclusion criteria comprised of women aged ≥18years, gestational age 28-40 weeks, singleton pregnancy, normotensive pregnant women, and pregnant women diagnosed with pre-eclampsia. The exclusion criteria included women with intrauterine fetal death, pregnant women with heart disease, acute fatty liver of pregnancy, chronic kidney disease, autoimmune disorders like systemic lupus erythematosus or antiphospholipid, and type 1 or type 2 diabetes. STATA 14.2 program was used for statistical analysis. Result: There were 188 pregnant women normotensive pregnancy (85.5%) and 32 pre-eclampsia cases (14.5%). Body mass index, blood pressure, mean arterial pressure, chronic hypertension, history of pre-eclampsia, birth weight, UtA-PI and notching showed an significant association with preeclampsia. The receiver operating characteristic curve (ROC) analysis was used. The ROC analysis result of UtA-PI was found as sensitivity 87.50% and specificity 98,94% (AUC: 0.9963, 95% CI: 0.99-1) with cutoff 1,22. and notching was found as sensitivity 46,88% and specificity 87,23% (AUC: 0.6705, 95% CI: 0.57-0.76). Conclusion: There are differences in the accuracy between UtA-PI and notching. UtA-PI has better performance the notching.