Background: Pre-eclampsia is associated with uteroplacental circulatory dysfunction, which may have a detrimental impact on foetal growth and oxygenation during pregnancy. the utilisation of colour Doppler investigations is a non-invasive, routine technique for haemodynamically evaluation of fetal well-being. The study was intended to investigate the value of middle cerebral artery (MCA) and umbilical artery (UA) Doppler indices in the assessment of foetal wellbeing and the prediction of neonatal outcome in expectant women with preeclampsia. Methods: This prospective cohort study was carried out on 100 pregnant women with preeclampsia at Benha University Hospitals. Participants were allocated into a good neonatal outcome group (n = 62) and a bad outcome group (n = 38) based on the presence of at least one adverse neonatal outcome. All participants underwent detailed clinical assessment, laboratory investigations, and ultrasonographic evaluation including fetal biometry and Doppler studies of UA and MCA, with assessment of RI, PI, and cerebroplacental ratio (CPR). Neonatal outcomes were assessed using Apgar scores, cord blood gas analysis, NICU admission, and predefined criteria for adverse outcomes including perinatal death and fetal distress. Results: The comparison among groups showed insignificant differences in UA PSV and EDV, while UA resistance indices were significantly elevated in the adverse outcome group RI, S/D ratio, PI (p < 0.001, = 0.002 and 0.001). MCA indices also differed significantly, with lower RI and PI and elevated S/D ratio (p < 0.001) in the adverse outcome group. Overall, UA 1 Page 8 of 26 - Integrity Submission 22 Submission ID trn:oid:::3618:134464763Page 9 of 26 - Integrity Submission Submission ID trn:oid:::3618:134464763 and MCA Doppler indices established a significant predictive ability (p < 0.001), with UA PI showing the best overall accuracy and MCA PI exhibiting the highest diagnostic performance (AUC = 0.975). 15 40 Conclusions: UA and MCA Doppler indices are useful for evaluating fetal well-being and predicting neonatal findings in preeclampsia. Increased UA resistance and decreased MCA resistance are associated with adverse outcomes, with UA PI and MCA PI showing strong predictive value for risk stratification. |
