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Abstract
Objective: To determine the determinants of adverse perinatal outcomes among high-risk pregnant women with abnormal uterine Doppler imaging.
Methods: This analytical cross-sectional study was conducted at the Department of Obstetrics and Gynecology of a tertiary care hospital over six months. A total of 162 high-risk pregnant women aged 18–45 years with abnormal uterine Doppler imaging were enrolled using consecutive non-probability sampling. Maternal demographic characteristics, obstetric history, comorbidities, and uterine artery Doppler parameters were recorded. Participants were followed until delivery, and adverse perinatal outcomes, including preterm birth, low birth weight, fetal growth restriction, low Apgar score, NICU admission, stillbirth, and perinatal death, were documented. Data were analyzed using SPSS version 26, and a p-value ≤0.05 was considered statistically significant.
Results: The mean maternal age was 29.8 ± 5.7 years. Adverse perinatal outcomes occurred in 69 (42.6%) pregnancies. The most common adverse outcomes were preterm birth (25.9%), low birth weight (23.5%), NICU admission (19.1%), and fetal growth restriction (17.3%). Preeclampsia was significantly more frequent among women with adverse outcomes than those without (46.4% vs. 9.7%; p<0.001). Elevated pulsatility index was observed in 75.4% of women with adverse outcomes compared with 46.2% of those without adverse outcomes (p<0.001). Multivariable analysis identified preeclampsia, elevated pulsatility index, and bilateral uterine artery notching as independent determinants of adverse perinatal outcomes.
Conclusion: Preeclampsia, elevated pulsatility index, and bilateral uterine artery notching were significant determinants of adverse perinatal outcomes among high-risk women with abnormal uterine Doppler imaging