Prevalence and Factors Associated With Abnormal Cerebroplacental Ratio Among Women With Hypertensive Disorders of Pregnancy at a Tertiary Referral Hospital in Southwestern Uganda.
| Title: | Prevalence and Factors Associated With Abnormal Cerebroplacental Ratio Among Women With Hypertensive Disorders of Pregnancy at a Tertiary Referral Hospital in Southwestern Uganda. |
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| Authors: | Ibrahim SS; Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.; Tornes YF; Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.; Kayondo M; Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.; Tsongo FK; Department of Radiology, Mbarara University of Science and Technology, Mbarara, Uganda.; Mugyenyi GR; Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.; Ngonzi J; Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.; Lugobe HM; Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.; Mugisha JS; Department of Radiology, Mbarara University of Science and Technology, Mbarara, Uganda.; Tibaijuka L; Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.; Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, Mbarara, Uganda. |
| Source: | Journal of pregnancy [J Pregnancy] 2024 Oct 17; Vol. 2024, pp. 8895971. Date of Electronic Publication: 2024 Oct 17 (Print Publication: 2024). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wiley Country of Publication: United States NLM ID: 101553823 Publication Model: eCollection Cited Medium: Internet ISSN: 2090-2735 (Electronic) Linking ISSN: 20902727 NLM ISO Abbreviation: J Pregnancy Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2024- : [Hoboken, NJ] : Wiley; Original Publication: Cairo : Hindawi Pub. Corp. |
| MeSH Terms: | Middle Cerebral Artery*/diagnostic imaging ; Hypertension, Pregnancy-Induced*/epidemiology ; Umbilical Arteries*/diagnostic imaging ; Tertiary Care Centers*; Uganda/epidemiology ; Placenta/blood supply ; Placenta/diagnostic imaging ; Humans ; Female ; Pregnancy ; Adult ; Cross-Sectional Studies ; Prevalence ; Ultrasonography, Prenatal ; Young Adult ; Pulsatile Flow ; Ultrasonography, Doppler ; Risk Factors |
| Abstract: | Background: Hypertensive disorders of pregnancy (HDP) are associated with placental insufficiency and adverse perinatal outcomes-over half (58.9%) of women with HDP at Mbarara Regional Referral Hospital (MRRH) have adverse perinatal outcomes. The cerebroplacental ratio (CPR) is an important predictor and prevents approximately 30% of these adverse perinatal outcomes. We determined the prevalence and factors associated with abnormal CPR among women with HDP at MRRH. Methods: We conducted a cross-sectional study from December 2022 to May 2023 at the high-risk obstetrics unit of MRRH. We consecutively enrolled all women with hypertensive disorders and gestational ages ≥ 26 weeks and performed obstetric Doppler studies to document the pulsatility index (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) and then calculated the CPR as a ratio of the MCA-PI and UA-PI. The prevalence of women with an abnormal CPR ≤ 1.0 was expressed as a percentage. We used robust modified Poisson regression analysis to determine the factors associated with abnormal CPR. Results: We enrolled 128 women with hypertensive disorders in pregnancy, with a mean age of 28.8 ± 6.3 years. Of these, 67 (52.3%) had abnormal CPR. The factors associated with abnormal CPR were severe pre-eclampsia (adjusted prevalence ratio (aPR): 5.0, 95% CI: 1.28, 29.14) and eclampsia (aPR: 5.27, 95% CI: 1.11, 34.27). Conclusion: On average, half of the women with hypertensive disorders have abnormal CPR. Women with severe pre-eclampsia or eclampsia are more likely to have abnormal CPR. Obstetric Doppler studies with CPR may be warranted for all pregnant women with severe pre-eclampsia and eclampsia. We recommend further research to assess perinatal outcomes among those with and without abnormal CPR to profile women with HDP at increased risk of adverse perinatal outcomes.; (Copyright © 2024 Suada Suleiman Ibrahim et al.) |
| Competing Interests: | The authors declare no conflicts of interest. |
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| Contributed Indexing: | Keywords: abnormal cerebroplacental ratio; hypertensive disorders of pregnancy; sub-Saharan Africa |
| Entry Date(s): | Date Created: 20241025 Date Completed: 20241025 Latest Revision: 20241026 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11502126 |
| DOI: | 10.1155/2024/8895971 |
| PMID: | 39449739 |
| Database: | MEDLINE |
Journal Article