Prevalence and Factors Associated With Abnormal Cerebroplacental Ratio Among Women With Hypertensive Disorders of Pregnancy at a Tertiary Referral Hospital in Southwestern Uganda.

IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Journal of Pregnancy Pub Date : 2024-10-17 eCollection Date: 2024-01-01 DOI:10.1155/2024/8895971
Suada Suleiman Ibrahim, Yarine Fajardo Tornes, Musa Kayondo, Fidel Kasereka Tsongo, Godfrey Rwambuka Mugyenyi, Joseph Ngonzi, Henry Mark Lugobe, Julius Sebikali Mugisha, Leevan Tibaijuka
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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.

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乌干达西南部一家三级转诊医院中患有妊娠高血压疾病的妇女脑-胎盘比例异常的患病率及其相关因素。
背景:妊娠期高血压疾病(HDP)与胎盘功能不全和不良围产期结局有关--在姆巴拉拉地区转诊医院(MRRH),一半以上(58.9%)的妊娠期高血压疾病妇女会出现不良围产期结局。脑-胎盘比率(CPR)是一个重要的预测指标,可避免约 30% 的围产期不良结局。我们确定了 MRRH 的 HDP 妇女中 CPR 异常的发生率和相关因素。方法:我们于 2022 年 12 月至 2023 年 5 月在瑞金医院高风险产科进行了一项横断面研究。我们连续登记了所有患有高血压疾病且孕龄≥26周的产妇,并对其进行了产科多普勒检查,以记录脐动脉(UA)和大脑中动脉(MCA)的搏动指数(PI),然后将MCA-PI和UA-PI的比值计算为CPR。CPR 异常≤1.0 的女性患病率以百分比表示。我们使用稳健的修正泊松回归分析来确定与 CPR 异常相关的因素。结果我们共招募了 128 名患有妊娠期高血压疾病的妇女,平均年龄为 28.8 ± 6.3 岁。其中 67 人(52.3%)心肺复苏异常。与 CPR 异常相关的因素是严重先兆子痫(调整后患病率比值(aPR):5.0,95% CI:1.0):5.0,95% CI:1.28,29.14)和子痫(aPR:5.27,95% CI:1.11,34.27)。结论平均而言,半数患有高血压疾病的妇女心肺复苏出现异常。患有严重先兆子痫或子痫的妇女更有可能出现心肺复苏术异常。所有患有重度子痫前期和子痫的孕妇都可能需要进行心肺复苏的产科多普勒检查。我们建议开展进一步研究,评估心肺复苏异常和心肺复苏未见异常孕妇的围产期预后,以确定 HDP 孕妇围产期不良预后的风险。
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来源期刊
Journal of Pregnancy
Journal of Pregnancy OBSTETRICS & GYNECOLOGY-
CiteScore
6.10
自引率
0.00%
发文量
15
审稿时长
14 weeks
期刊介绍: Journal of Pregnancy is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to all aspects of pregnancy and childbirth. The journal welcomes submissions on breastfeeding, labor, maternal health and the biomedical aspects of pregnancy.
期刊最新文献
Magnitude and Associated Factors of Herbal Medicine Use During Pregnancy Among Women Attending Antenatal Care in Public Health Institutions of Central Tigray, Northern Ethiopia (2020): Facility-Based Cross-Sectional Study. Prevalence and Factors Associated With Abnormal Cerebroplacental Ratio Among Women With Hypertensive Disorders of Pregnancy at a Tertiary Referral Hospital in Southwestern Uganda. Development, Validation, and Diagnostic Accuracy of the Fetal Lack of Responsiveness Scale for Diagnosis of Severe Perinatal Hypoxia. Navigating Pregnancy: Information Sources and Lifestyle Behavior Choices-A Narrative Review. The Impact of Fetal Growth Restriction on Prenatal 2D Ultrasound and Doppler Study of the Fetal Adrenal Gland.
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