Three-dimensional modeling of the umbilical artery Doppler and its applications in preeclampsia assessment: a case-control study
Ultrasound and Doppler indices were implemented to screen high-risk pregnancies as preeclampsia, a unique pregnancy syndrome that imposes many challenges on the mother and her unborn child. Since there is currently no conscience of what parameter is best for screening, this study was designed to examine if a 3-dimensional re-modeling of a 2-dimensional Doppler wave will perform better in PE screening and evaluating its severity.
A case-control study enrolled 90 eligible primigravida’s age and body mass index-matched screened and followed till 34 weeks, where they were re-grouped into controls; and preeclampsia (PE) cases (45/90) each. Demographic, biochemical, and hematological parameters were tested; followed by ultrasonic parameters [amniotic fluid index, estimated fetal weight, resistance, and pulsatility index (RI and PI)].
From Doppler strip, 5 heights were taken from a heartbeat for every patient to measure the volume under the surface (VUS) of 3 dimensional modeled Doppler. VUS was significantly low among PE cases, with strong significant associations; (P < 0.001) with biochemical, hematological, and ultrasonic parameters that define PE onset and severity. Furthermore, VUS discriminated PE cases at a cut-off value of < 66 unit3, associated with 93.3%,92%, and P-value<0.001 sensitivity and specificity, respectively.
VUS’s strong relations and high discrimination power regarding PE onset and severity make it a recommendable parameter. It is simple and has an easy technique, without extra charge. We recommend incorporating it into anti-natal care services. More studies are warranted to unveil prognostic and other diagnostic applications in practice.