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Background: Gestational hypertensive disorders are major cause of maternal and fetal morbidity and mortality with increased risk for abruptio placentae, acute renal failure disseminated intravascular coagulation, pulmonary edema, circulatory collapse, convulsions, fetal prematurity, intrauterine growth retardation and intrauterine fetal death.
Objectives: The aim of the study was achieved by getting two standard evaluations of the three ultrasonographic characteristics to answer the following research questions; (1) Does the use of special ultrasonographic fetal monitoring techniques (umbilical artery Doppler, amniotic fluid index and ultrasound fetal biometry) predict outcome of pregnancy? (2) What are the short term outcomes associated with abnormalities of the three characteristics outlined above?
Methods: The study employed a descriptive prospective cross-sectional hospital based study to evaluate 60 fetuses (60 mothers) referred to KCMC for gestational hypertension by evaluation of the three ultrasonographic characteristics, fetal biometry, amniotic fluid index and umbilical artery resistive index.
Results: Resistive index of umbilical artery proved to be a more sensitive test as an earlier indicator of fetal compromise before any other ultrasonographic characteristic or distress becomes obvious. In contrast, abnormalities in amniotic fluid index and IUGR with development of fetal distress occur relatively late reflecting the degree of imminent fetal risk.
Conclusions: The study showed that the main suggested implications for management are of avoidance of preterm delivery with normal ultrasonographic characteristics. The incidence and severity of poor fetal outcome may be reduced with early introduction of regular obstetrical ultrasound fetal surveillance in PIH with medication for blood pressure control. |
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