Association between ophthalmic artery Doppler indices and adverse perinatal outcomes in women with pre-eclampsia in Kano, Nigeria

Abstract

Background: - Pre-eclampsia (PE) as a pregnancy-related hypertensive disorder poses a significant challenge to maternal and foetal health in low and middle-income countries, like Nigeria. The ophthalmic artery Doppler (OAD) is a tool that has been studied to aid in diagnosing PE, since its pathogenesis is not limited to the placental bed, but extends to cardiovascular and endothelial adaptations during pregnancy. Abnormal maternal ophthalmic artery Doppler velocimetry is associated with poor perinatal outcomes. Objectives: - To determine ophthalmic artery Doppler velocimetric indices of patients with pre-eclampsia using ultrasonography and correlate these indices with pregnancy-related outcomes. Materials and methods: - This was an observational cohort study carried out at a tertiary hospital in Nigeria. Eighty-two pre-eclamptic patients and an equal number of normotensive-matched pregnant controls were recruited for the study. The ophthalmic artery peak ratio, pulsatility index, and resistive index of both groups were obtained using high-resolution ultrasound Doppler examination. These parameters were then correlated with selected maternal and perinatal outcomes. Results: The mean age of pre-eclamptic subjects (28years ± 3.86) and that of the control subjects (27.52years ± 4.36) were not statistically different (p = 0.444). Gestational ages were also similar between the two groups (pre-eclamptic: mean = 33.24weeks ± 2.89; normotensive: mean 33.41weeks ± 3.72; p = 0.74).

The ophthalmic artery RI, PI and PR were significantly associated with adverse perinatal outcomes. These outcomes include: low birthweight (p = 0.01) stillbirth (P < 0.003) and depressed Apgar score (p = 0.001).  Conclusions: This study found significant association between ophthalmic artery velocimetric indices and adverse perinatal outcomes, suggesting that ophthalmic artery Doppler can enhance risk stratification and improve perinatal outcomes.