Correlation of Uterine Artery Doppler Velocimetry With Laboratory Findings in Patients With Severe Preeclampsia Presenting to Kenyatta National Hospital

Abstract

Background Preeclampsia complicates 2-8% of pregnancies worldwide and it is a recognized cause of maternal morbidity and mortality. Uterine artery Doppler velocimetry is a non-invasive method that is utilized in pregnancy to monitor both the foetus and the mother. Uterine artery Doppler studies are currently performed in patients with preeclampsia and they can, therefore be used to predict the presence or absence of abnormal laboratory findings in these patients, and therefore, expedite referral and management. Objective The purpose of this study was to correlate the uterine artery Doppler waveforms and indices with laboratory findings in consenting obstetric patients presenting to Kenyatta National Hospital, with severe preeclampsia Methodology A prospective cross-sectional study of patients presenting to Kenyatta National Hospital maternity ward with severe preeclampsia was conducted between November 2020 and April 2021. We recruited 80 pregnant women with singleton pregnancies above 20 weeks’ gestation, however 3 were later excluded, leaving a total of 77 patients. A structured questionnaire was used for demographic, clinical and radiological data. An obstetric ultrasound, including bilateral uterine artery Doppler studies was performed. Laboratory values of Aspartate transaminase (AST) & alanine aminotransferase (ALT), creatinine levels and platelet counts obtained soon after admission were recorded into the data abstraction form. The data was then entered into and analysed on R Studio software using R version 4.0.2 and was presented on tables and graphs. Results Out of 77 patients, abnormal uterine artery Doppler findings were seen in 64 (83.1%) patients. Liver dysfunction, renal impairment or thrombocytopenia was found present in 26 (33.8%) patients. Abnormally elevated ALT levels were recorded in 13 (16.0%) compared to 8 (10.4%) patients with abnormally elevated AST levels. There was an association between uterine artery notching, abnormal uterine artery resistive indices and elevated ALT [OR = 74.85, 95% (CI 8.07 – 2035.35)] and [OR = 16.24, 95% (CI 2.52 – 335.80)] respectively. Elevated creatinine levels were seen in 14 (18.2%) patients and there was a significant association between uterine artery notching and elevated creatinine [OR = 6.15, 95% (CI 1.56 –.........................................................................