Which is Superior, Doppler Velocimetry or Non-stress Test or Both in Predicting the Perinatal Outcome of High-Risk Pregnancies

摘要

Aim and Objectives To analyze which is superior, Doppler velocimetry or non-stress test or both by means of categorization into four groups and comparing the prediction of perinatal outcome in high-risk pregnancies like anemia, hypertensive disorders of pregnancies. Materials and Methods This was a prospective study conducted at the Department of Obstetrics and Gynaecology, ISO KGH, Madras Medical College, Chennai, in the year 2014. Two hundred high-risk pregnancies like anemia, hypertensive disorders of pregnancy were included in the study. They were examined systematically, and Doppler velocimetry and non-stress test were done. The main vessels studied by Doppler were umbilical artery and middle cerebral artery, and the indices were calculated. The results of the non-stress test were interpreted as reactive and non-reactive. Based on the results of Doppler and non-stress test, the 200 cases were categorized into four groups and the results were analyzed. Results Among the 200 cases of high-risk pregnancies, those with a normal Doppler study and a reactive non-stress test had good perinatal outcome. When both were abnormal, there was a higher percentage of adverse outcome as compared to that of either Doppler alone being abnormal or non-stress test alone being non-reactive. It was also found that abnormal Doppler but with a reactive non-stress test had the advantage of prolonging the pregnancy and bringing a better outcome indicating that non-stress test is surely a good test of well-being. When Doppler was normal, but non-stress test was non-reactive, there was an increase in the rate of cesarean section. Conclusion Each method of fetal surveillance reflects different aspect of maternal and fetal pathophysiology. Hence, combining these will help to bring out better perinatal outcome.