Role of non stress test and umbilical artery doppler velocimetry for assessment of fetal outcome in high risk pregnacy


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Joslin Susan Joy., Mallika and Sangeerani

Aim: To compare the efficacy of Non Stress Test and Umbilical Artery Doppler velocimetry in assessing the fetal outcome in high risk pregnancy.

Matierials and methods: In a prospective observational study, 100 pregnant women among the high risk group were monitored with Non Stress test and Umbilical artery Doppler velocimetry. The study consists of 25 women who underwent NST, another 25 for whom fetal Doppler was done and another 50 women for whom both NST and Doppler were conducted and followed up. All these three groups were followed up and compared. The feta outcome were evaluated in all these three groups in terms of mode of delivery, colour of liquor, Apgar score and duration of NICU admission.

Results: The mean gestational age was 37.72 in Group I and 36.12 in Group II. The mode of delivery was predominantly LSCS among those women with abnormal NST alone (87.5%) and those with both abnormal NST and Doppler waveforms (100%). The Apgar score at 5 minutes was below 7 among 76% patients with abnormal NST. Meconium stained liqour was predominant among those patients with abnormal NST (50%). These differences were found to be statistically significant.

Conclusion: Screening of high risk pregnancies with both Doppler and NST was better than either test alone, because Doppler detected fetal compromise earlier than NST, giving a lead time which was more important in management of preterm pregnancies. Prognosis was best when both NST and Doppler were normal and worst when both the tests were abnormal. It was better to deliver the fetus before NST becomes abnormal. Disadvantages of Doppler over NST was the requirement of sophisticated equipment and also experienced persons were essential to perform the test.

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