Pre-eclampsia, one of the most common complications during pregnancy due to lack of proper treatment, may lead to mortality and morbidity. Early prediction and proper treatment can be possible by gathering clinical information through an ultrasound. This blog article aims to convey the role of Ultrasound in Pre-eclampsia assessment.
What is Pre-eclampsia?
Preeclampsia is a condition during pregnancy when you have high blood pressure and a high amount of protein present in the urine, or different signs of organ damage. Preeclampsia usually starts after 20 weeks of pregnancy.
Pre-eclampsia assessment involves checking blood pressure and protein level in urine through some blood and urine tests.
Methods to detect pre-eclampsia?
The assessment of Pre-eclampsia is suggested when you have high blood pressure after 20 weeks of pregnancy. If, along with high blood pressure, one of the following conditions is found:
- Proteinuria, or the presence of a high amount of protein in urine
- Some signs of a kidney problem
- Blood platelet count is low
- Pulmonary edema is the fluid in the lungs
There are several ways for Preeclampsia assessment, and they are as follows:
- Blood test
During pregnancy, the systolic pressure is 140 millimeters of mercury (mmHg) and the diastolic pressure is 90 millimeters of mercury (mmHg). If you have high blood pressure, your health care provider will recommend the following tests for the early detection of preeclampsia. The blood sample has been analyzed to assess the condition of both the kidney and liver. The amount of platelets can also be measured through a blood test.
- Urine test
Your doctor will recommend a 24-hour urine sample and a single urine sample to ensure the function of the kidneys.
- Fetal Ultrasound
There are several advantages of having ultrasound in Pre-eclampsia assessment. Your health care provider will ask you for an Ultrasound to monitor your baby’s growth. In ultrasound, the weight of the baby and the amount of fluid in the uterus can be measured by the images of the baby created on a monitor.
- Biophysical profile or Non-stress Test
A Nonstress test checks the baby’s heart rate when your baby moves. The biophysical profile measures the breathing muscle tone of your baby, movement, and the volume of fluid in the uterus, through ultrasonography.
How Ultrasound Works to Detect Pre-eclampsia?
Ultrasonography is an early screening method to recognise the risk factors in pregnancy. There are several benefits of having ultrasound in Pre-eclampsia assessment. The way ultrasound detects Preeclampsia is as follows:
1. Sound wave
The transducer of ultrasonography produced a high-frequency sound wave that travels in the body.
2. Echo
The wave bounces off different organs and tissues, including the blood cells of the uterine artery. Then the sound returns to the transducer in the form of an echo.
3. Colour Doppler Test
Colour Doppler ultrasound visualises the blood flow with the help of the echo. As the pregnancy progresses, the resistance in the uterine arterioles decreases.
4. Uterine artery pulsatility index (UtA-PI)
UtA-PI denotes Uterine artery pulsatility Index is a kind of measurement based on Doppler ultrasound to evaluate the resistance to blood flow in the artery of the uterus. There are two types of conditions, such as high UtA-PI and low UtA-PI.
- High UtA-PI – It indicates high resistance to blood flow may lead to inadequate development of the placenta. High utA-PI can be a risk factor for Preeclampsia.
- Low UtA-PI- This condition can be found in normal pregnancy with a well maintained blood flow.
5. Mean arterial pressure (MAP)
MAP(Mean Arterial Pressure) is an effective biophysical marker to detect pre-eclampsia conducted during the second trimester of pregnancy. It indicates the average pressure in the arteries in a cardiac cycle. There is an increasing risk of pre-eclampsia if the MAP is found to be 88.5 or 93.67 mmHg. It is a significant indicator of rising systolic as well as diastolic pressure in the second trimester.
6. Early Diastolic Notch
One of the major indicators of Pre-eclampsia is the presence of an early diastolic notch, a dip in the waveform of blood flow.
Role of PAPP-A and PLGF in Pre-eclampsia
In detecting Preeclampsia, PAPP-A& PIGF are the biomarkers performed during the first trimester of pregnancy.
1. PAPP-A in Pre-eclampsia
- Function of PAPPA-A
PAPP-A is a kind of metalloproteinase, which stands for Pregnancy Associated Plasma Protein-A, that contributes to regulating the insulin-like growth factor bioavailability, which is needed for placental growth as well as the development of the fetus.
- Role of PAPP-A
Low PAPP level indicates the potential risk of Preeclampsia.
2. PIGF in Preeclampsia
- Function of PIGF
The vascular endothelial growth factor PIGF is essential for healthy placental vascular development.
- Role of PIGF
The reduced Low PIGF level indicates the development.
Preterm Pre-eclampsia can be detected during the first trimester by the PAPP-A& PIGF testing.
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Conclusion
Ultrasonography is essential for the assessment of Pre-eclampsia during Your pregnancy. The underlying causes of Preeclampsia, which is the abnormal placental development, can be recognised through ultrasonography. It can also detect the growth and condition of the fetus. By evaluating the blood flow in the uterine artery, ultrasound detects the signs of Preeclampsia. Here, the methods to assess Preeclampsia and its advantages are discussed briefly. The benefits of ultrasound in Pre-eclampsia assessment have been emphasized in this article. Consulting with your health care provider is necessary to avoid such complications during your pregnancy.
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