الفهرس 
List of AbbreviationsOnly 14 pages are availabe for public view
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Abstract
Hypertensive disorders complicating pregnancy are common and form one of the deadly triad, along with hemorrhage and infection, that contribute greatly to maternal morbidity and mortality. br Preeclampsia is -#99;-#104;-#97;-#114;acterized by a BP of 140/90 mm Hg or greater after 20 weeks’ gestation in a women with previously normal BP and who have proteinuria (≥0.3 g protein in 24-h urine specimen). br preeclampsia accounts for approximately (5-8%) all over the world and Severe preeclampsia accounts for approximately 25% of all cases of preeclampsia br In this study which included 100 women with preeclampsia admitted to Sohag Maternity University Hospital the aim was to assess the accuracy of Doppler indices of umbilical, middle cerebral and uterine arteries especially the accuracy of middle cerebral/umbilical artery pulsatility index ratio in predicting admission to NICU, acidemia and low Apgar score at 5 minutes after birth in neonates of preeclamptic pregnant women. Also, to provide basis for use of Doppler tests in adopting management protocols for preeclamptic patients. br There was a positive significant correlation between MCA/UA PI ratio -lt;1 and higher rates of NICU admission, 5 minutes Apgar score -lt;7, but there was no significant differences between women who had a MCA to UA PI -lt;1 and umbilical artery PH -lt;7.2. br The best cut off value of MCA/UA PI ratio for prediction of NICU admission was sensitivity 62.5%, specificity 71.43%, PPV 29.41%, NPP 90.91% and the accuracy 70%, the cut off value of MCA/UA PI ratio for prediction of low Apgar score at 5 min was sensitivity 50% and 88.10% specificity, estimated positive predictive value =44.44 and negative predictive value =90.24, and the cut off value of MCA/UA PI ratio for prediction of low UA PH was sensitivity 43.75%, specificity 69.05%, estimated positive predictive value =21.21, and negative predictive value =86.57. br MCA PI/UA PI ratio was found to be more sensitive and more specific in prediction of poor neonatal outcome in patients with preeclampsia specially in prediction of Apgar score at 5 minutes and incidence of NICU admission. br There was positive correlation between MCA/UA PI ratio and NICU admission as correlation coefficient = p value = 0.181, as Apgar score at 5 min there was poor correlation with p value =0.171 but there was negative correlation with umbilical cord PH with p value =0.536. br Considering that MCA PI / UA PI ratio reflects not only the circulatory insufficiency of the placenta by alteration in the umbilical pulsatility index, but also the adaptive changes resulting in modification of the middle cerebral pulsatility index, it seemed to be a potentially useful tool in predicting neonatal adverse outcome. br Doppler data combining umbilical, cerebral and uterine artery velocimetery provide information on consequences of the placental abnormality; hence Doppler can be a useful tool in the management of patients with preeclampsia and can help in deciding the time of delivery so that the fetus can be saved. br Conclusion and Recommendations br • Preeclampsia during pregnancy is the most common medi cal condition encountered. Doppler analysis helps not only earlier detection of uteroplacental and fetoplacental changes associated with the disease but also helps to take decision for early intervention. br • Umbilical artery Doppler has got better sensitivity and predictive value for fetal adverse outcome. Abnormal fetoplacental circulation is more associated with adverse outcome as compared to abnormal uteroplacental circulation. br • Umbilical artery Doppler findings are slight better predictor of adverse perinatal outcome than an abnormal MCA. br • Perinatal morbidity and mortality can be reduced by fetal surveillance with Doppler velocimetry study.In this small and preliminary study we have assessed the role of Doppler ultrasound and found it to be a useful technique for fetal well-being evaluation and predicting perinatal outcome. br • We recommend adding MCA (PI)/ UA (PI) ratio to routine antepartum fetal surveillance -#102;-#114;-#111;-#109; 32 weeks gestations for women with preeclampsia as there is a strong correlations between it and poor neonatal outcome.