Association between Foetal Umbilical Artery Waveforms and Foetal Outcomes in Patients with Pre-eclampsia: An Analytical Cross-sectional Study at Federal Teaching Hospital, Gombe, North-eastern Nigeria

Abstract

ABSTRACT

Background:  Globally, pre-eclampsia is a major cause of maternal and perinatal morbidity and mortality. In Nigeria, it is identified as the primary cause of maternal complications. The objective of this study is to examine the association between foetal outcomes in patients with pre-eclampsia and the Doppler waveform of the umbilical artery at Federal Teaching Hospital Gombe (FTHG). Studies have shown umbilical artery Doppler can predict adverse foetal outcome early than the other methods before delivery of the foetus by a means difference of 9.2 days plus or minus 4days

Materials and methods: A cross-sectional study was carried out at the antenatal clinic and gynecological emergency unit of Federal Teaching Hospital Gombe (FTHG), involving 96 patients who were diagnosed with pre-eclampsia. The samples were selected using convenience sampling techniques. The umbilical artery Doppler waveform was tested at the laboratory while the fetal outcome and maternal information/socio-economic information of the sampled women were collected from labor ward and semi-structured interviewer-administered questionnaire. Chi-square test was employed in analyzing the data collected  with a significance level set at a p-value of less than 0.05.

Results: Of the 96 respondents studied, almost ¹/₃ of the studied patients exhibited abnormal umbilical artery waveforms, which varied in severity. These abnormalities included reduced end diastolic flow in 27 accounting for about quarter of the studied cases, reversed end diastolic flow was observed in only 2 (2.1%) cases, and absent end diastolic flow in 1 (1.0%) case. It was observed that those with abnormal umbilical artery Doppler waveforms were seven times  more likely to give birth to low birth weight babies (OR=7.09, p-value=0.008, 95% CI=1.494 – 14.041) and five times more likely to require admission to a special care baby unit (SCBU) (OR=5.06, p-value=0.024, 95% CI=0.088 – 0.846).

Conclusion: This study established a strong association between abnormal umbilical artery Doppler waveforms in women with pre-eclampsia and the likelihood of their babies being born with low birth weight and admission to SCBU. Therefore, the findings can serve as a guide in the timing of delivery for patients with pre-eclampsia. In addition, they can be used as an indication for referrals by facilities without SCBU and which cannot manage low birth weight babies in their hospital.

Keywords: foetal umbilical artery; pre-eclampsia; foetal outcome; Federal Teaching Hospital,

Gombe