Biography
Biography: Pankaj Desai
Abstract
Title: New tools in prediction of Preeclampsia
Preeclampsia remote from term (onset at or before 32weeks of pregnancy) is one of the major obstetric vasculopathies. As the cause remains elusive, its prediction is much sought after. History-based prediction of preeclampsia is very inefficient. So, currently, a combination of one imaging and one biochemical parameter is popularly used in prediction of this type of preeclampsia. This is logistically taxing and costly. However, we are using tools based only on uterine artery color Doppler to predict preeclampsia, efficiently. We use the uterine artery diastolic notch, its presence or absence as well as its configuration to predict preeclampsia. This is further reinforced by its combination with other parameters on color Doppler. In I-trimester, if the Diastolic Notch (DN) is absent and pulsatility index (PI) of the uterine artery is less than 1.7, the subject is low-risk for developing preeclampsia. On the other hand, if DN is present its configuration is studied. It is expressed as NDI or Notch depth Index. If NDI is more than 0.55 and DN is more than 1.7, this subject is at high risk for developing preeclampsia. Preventive measures like low dose aspirin as started in them. In II Trimester (at mid-trimester 20 weeks) if DN is still present and PI falls by less than half, we continue preventive measures. This indicates that the process of obstetric vasculopathy is still on. However in subjects in whom DN disappears at mid-trimester and PI falls by half or more as compared to I-Trimester, this is a low-risk subject for preeclampsia. In these subjects, if any preventive measures have been ongoing, they can be stopped. These new tools for predicting preeclampsia are found to be easy to perform, alleviates the need for biochemical marker and so only one technology is needed and are quite efficient.