Comparison of Biophysical Profile Score with Fetal Doppler Ultrasound in Patients with Pre-eclampsia at Moi Teaching and Referral Hospital, Kenya

Abstract

Background: Pre-eclampsia is a major direct cause of maternal mortality second only to hemorrhage with 50,000-60,000 pre-eclampsia related deaths worldwide annually. Pregnancies complicated by preeclampsia require close fetal surveillance to guide management and improve outcomes. Poor Biophysical profile scores are associated with poor perinatal outcomes. Recent research has however shown that Doppler flow changes occur much earlier and can be used to time delivery with better perinatal outcomes. Objective: To compare Doppler indices of the umbilical and middle cerebral arteries with biophysical profile scores in the prediction of perinatal outcomes in patients with pre-eclampsia. Methods: This was a cross sectional study. Patients with preeclampsia above 28 weeks gestation were consecutively sampled, questionnaires administered, ultrasound done, followed up to delivery and outcomes documented. Statistical analysis was done using STATA/MP version 13.0. Results: One hundred and sixty-five patients whose ages ranged from 15-42 years with an average of 29 years were studied. Majority (72.7%) presented between 28-34 weeks and 66.06% had pre-eclampsia with severe features. An abnormal outcome was seen in 86.4% of those who had abnormal Biophysical Profile (BPP) scores and abnormal BPP increased the Odds of poor outcome 4.95 times (p<0.001). An abnormal outcome was seen in 80% of those who had abnormal Doppler findings and abnormal Doppler findings increased the Odds of poor perinatal outcome 11.5 times (p<0.001). Conclusion: Abnormal BPP and Doppler findings were significantly associated with poor perinatal outcomes with Doppler being a better predictor