ROLE OF DOPPLER ULTRASONOGRAPHY IN PREDICTING ADVERSE FETOMATERNAL OUTCOMES IN HIGH-RISK PREGNANCIES: A PROSPECTIVE OBSERVATIONAL STUDY

Background: High-risk pregnancies are associated with increased maternal and perinatal morbidity and mortality, primarily due to impaired uteroplacental circulation. Doppler ultrasonography is a non-invasive modality used to assess fetal and placental hemodynamics and predict adverse outcomes.

Objectives: To evaluate the role of Doppler ultrasonography in predicting adverse fetomaternal outcomes in high-risk pregnancies and to determine the diagnostic accuracy of various Doppler indices.

Methods: This prospective observational study was conducted at Vedantaa Institute of Medical Sciences, Dahanu, Maharashtra, from January 2025 to October 2025. A total of 53 pregnant women with high-risk pregnancies (≥28 weeks gestation) were included. Doppler assessment of the umbilical artery (UA), middle cerebral artery (MCA), uterine artery (UtA), and cerebroplacental ratio (CPR) was performed. Participants were followed until delivery, and maternal and neonatal outcomes were recorded. Statistical analysis was performed using SPSS, and diagnostic accuracy was assessed using sensitivity, specificity, and ROC curve analysis.

Results: Adverse fetomaternal outcomes were observed in a substantial proportion of cases. Abnormal Doppler indices were significantly associated with poor outcomes. CPR showed the highest predictive accuracy with an AUC of 0.79 (95% CI: 0.66–0.91; p<0.001), followed by UA Doppler (AUC: 0.73), MCA Doppler (AUC: 0.71), and UtA Doppler (AUC: 0.68). CPR demonstrated higher sensitivity, while UA Doppler showed higher specificity. Neonatal complications such as low birth weight, preterm delivery, and NICU admission were more frequent in cases with abnormal Doppler findings.

Conclusion: Doppler ultrasonography, particularly CPR, is an effective tool for predicting adverse fetomaternal outcomes in high-risk pregnancies. Its routine use can aid in early detection of fetal compromise and guide timely clinical interventions.