correlation of 1 trimester uterine artery

correlation of 1 trimester uterine artery doppler

1. Title of Thesis Correlation of first Trimester Uterine Artery Doppler With Obstetric outcome

2. Name of Guide - Dr. Savita Rani Singhal Senior Professor, Unit head Department of Obstetrics and Gynaecology PGIMS ,Rohtak Name of Co-Guide - Dr. Menka Verma Associate professor Department of Obstetrics and Gynaecology PGIMS ,Rohtak Name of Co-Guide - Dr. Jyotsna Sen Senior Professor and head Department of Radiodiagnosis PGIMS, Rohtak Name of Candidate – Dr. Radhika Garg Postgraduate student Department of Obstetrics and Gynaecology PGIMS ,Rohtak

3. Research Question Whether First trimester Mean Uterine Artery Doppler values affects Obstetric outcome?

4. Aim and objectives AIM of the study : To study the relation of first trimester Uterine Artery Doppler with fetomaternal outcome . Objective of the study: To find out the relation of first trimester Uterine Artery Doppler with maternal outcome. To find out the relation of first trimester Uterine Artery Doppler with fetal outcome. To find cutoff values of Mean of Uterine Artery Doppler in first trimester in relation to fetomaternal outcome.

5. Material and Method The present study will be conducted in the department of Obstetrics and Gynecology and Radiodiagnosis at Pt. B.D. Sharma PGIMS Rohtak on women attending antenatal OPD at 11 – 13 weeks + 6 days after taking informed and written consent. Type of study: Prospective observational study. Study period : One year

6. Inclusion and exclusion criteria Inclusion criteria All primigravida Singelton pregnancy Between 11 – 13 weeks + 6 days of gestation. Exclusion criteria Multiple pregnancy Foetal anomalies Pregnancy with history of diabetes mellitus with vasculopathy, Chronic Hypertension, SLE, renal diseases.

7. Sample size was calculated on basis of previous study ( Jayson JA, Mandrelle K, Dhar T, Singla S. First trimester uterine artery Doppler screening in the prediction of adverse pregnancy outcomes. Int J Reprod Contracept Obstet Gynecol. 2021;10:3933-41 ) In the study, Type I error (Alpha, Significance), Zα was 1.96, Z1-β was 0.84, power was 80%, percentages of effect (▲) was 24.2% and standard deviation (σ) was 0.8. Formula was N=2 (Zα + Z1-β) 2 * σ 2 / ▲ 2 = 2 * (1.96+0.84) 2 * (0.8) 2 / (0.24) 2   = 15.68 * 0.64 / 0.05   = 10.03 / 0.05   = 200.704   = 200   Hence, the sample size of total 200 will be taken.   .

8. A total of 200 primigravida will be included in the study after fulfilling the eligibility criteria. Detailed history regarding the demographic profile, menstrual cycles, obstetric profile will be taken and clinical examination in reference to general physical, systemic and per abdomen examination will be carried out as per proforma.   All preliminary investigations including haemoglobin studies, blood grouping and Rh typing, glucose challenge test (GCT), TSH, HIV, STS, HBsAg, urine routine and microscopy, any additional investigation if indicated will be performed as per proforma. Gestosis score will be calculated at each visit (Annexure I). Transabdominal ultrasound will be conducted, Fetal maturity, crown rump length (CRL), nuchal translucency thickness(NT) and UAPI for bilateral uterine arteries will be measured at 11-13 + 6 weeks by Doppler ultrasound. A midsagittal section of the uterus will be obtained and cervical canal and internal cervical os will be identified and transducer will be used to localize each uterine artery at the level of internal os . A pulsed-wave doppler with the sampling gate set at 2mm away from internal os with angle of insonation less than 30° is applied, when three similar consecutive waveforms are obtained, the UAPI will be measured and the mean UAPI of left and right uterine artery will be calculated. 18 Mean of bilateral Uterine Artery Doppler in first trimester will be correlated with fetal and maternal outcome at cutoff values. Patient will be followed till delivery or abortion as per hospital protocol.   Details regarding development of preeclampsia, Intrauterine growth restriction, oligohydramnios, fetal distress, preterm labour or any pregnancy complications, mode of delivery and postnatal complications will be noted down. The details of the baby like weight of baby, sex, maturity, APGAR score, meconium staining, admission of baby to neonatal intensive care unit (NICU) and neonatal complications will be recorded.