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To determine the efficacy of uterine artery pulsatility index and pregnancy associated plasma protein-a in the first trimester as a predictor of gestational hypertension- A prospective observational cohort study

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Original Article

Author Details : Rakhee R Sahu*, Divya

Volume : 6, Issue : 4, Year : 2019

Article Page : 509-515

https://doi.org/10.18231/j.ijogr.2019.110

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Abstract

Hypertensive disorders complicates 5-10% of all pregnancies. WHO has found that 16% of maternal deaths
worldwide are due to gestational hypertension.
Aim: To determine the efficacy of uterine artery pulsatility index (UA-PI) and Pregnancy associated plasma
protein A (PAPP-A)done in the first trimester as a predictor of gestational hypertension(GHT) and adverse
fetal outcomes like fetal growth restriction, Small for gestational age babies, Preterm deliveries.
Materials and Methods: This is a prospective observational cohort study of 287 antenatal women, whose
1st trimester UA-PI and PAPP-A MoM values were obtained.
Results: Of the total 287 women, 68 (23.7%) developed GHT and 31 women developed adverse fetal
outcomes.
28 women (9.8%) had an abnormal UA-PI (>/= 2.70) and 11 (3.8%) women had an abnormal PAPPA
value (<0> hypertension. The sensitivity of UA-PI for prediction of GHT was 35.29%, specificity-98.17%, accuracy-
66.73% and p-value-0.0005 which is statistically significant. Of the 11 women who had abnormal PAPPA
MoM value, 3 developed GHT. The sensitivity of PAPP-A for the prediction of GHT was 4.41%,
specificity- 96.35% , and p-value was 0.925 which is statistically insignificant.
Conclusion: The study shows that 1st trimester UA-PI levels can be considered as a good predictor of
GHT, while PAPP-A- was not reliable predictor for GHT. Both UA- PI and PAPP-A value, were not found
to be useful markers in the prediction of adverse fetal outcomes in my study.

Keywords: Gestational hypertension, Uterine artery – Pulsatility index, serum. PAPP-A level.

How to cite : Sahu R R, Divya, To determine the efficacy of uterine artery pulsatility index and pregnancy associated plasma protein-a in the first trimester as a predictor of gestational hypertension- A prospective observational cohort study. Indian J Obstet Gynecol Res 2019;6(4):509-515

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