Evaluation of Maternal Ophthalmic Artery Doppler Velocimetry at 18 to 24 Weeks of Gestational Age in the Prediction of Preeclampsia.

Background: Preeclampsia (PE) is a crucial health issue that complicates roughly 10% of gestations and causes more than 50,000 deaths yearly worldwide. Most women with PE have mildly high blood pressure, a small amount of excess protein in the urine, and they do not experience any symptoms of the disease. This is the reason that prenatal screening of increased blood pressure is done in later pregnancy period. Aims and Objectives: The aim of this study was to evaluate the role of maternal ophthalmic artery Doppler velocimetry in predicting PE. The objectives were to examine the velocimetry values in the women undergoing antenatal scan at 18 to 24 weeks of gestation and their potential value in the subsequent development of PE. Materials and Methods: A prospective observational study was conducted on 800 women who visited the hospital for antenatal ultrasound at 18 to 24 gestational weeks. Ophthalmic artery Doppler study was conducted to obtain the spectral waveform from both eyes after recording the patient history. Doppler indices like first peak systolic velocity (PSV1), second peak systolic velocity (PSV2), pulsatility index (PI), end-diastolic velocity (EDV), resistivity index (RI), systolic/diastolic ratio (S/D), and PSV2 to PSV1 ratio (PSV ratio: PSV2/PSV1) were obtained and their average values were obtained. All patients were then followed up till termination of pregnancy to document the development of PE. Statistical Analysis: The collected data were entered into the Microsoft Excel and then analyzed and statistically evaluated using SPSS-25 version. Results: The study revealed that a total 95 subjects developed PE (11.9%) from a total of 800 subjects. The ophthalmic artery PSV2/PSV1 ratio and PSV2 of right and left eye were significantly increased in patients with PE. The EDV in pre-eclamptic patients was also increased as compared to normotensive patients. The average values of the PI and RI were decreased in PE patients as compared to normotensive patients. The S/D ratio was also decreased in patients who later developed PE as compared to normotensive patients. Conclusion: Ophthalmic artery Doppler velocimetry can detect PE in early stages and is a cheap, noninvasive, readily available, safe, and reliable tool for evaluation of hemodynamic changes in normotensive pregnancy, and even more so in PE. The most reliable parameters being the PSV2 and PSV2/PSV1 ratio with sensitivity of both the parameters being more than 90%. The other parameters like increased EDV and decreased PI and RI also have some role.