Colour Doppler Evaluation in High-Risk Pregnancies and Its Predictive Value for Adverse Perinatal Outcomes: A Prospective Observational Study

Abstract

Objective: To determine the role of Third Trimester Color Doppler in high risk pregnancies and their fetomaternal outcomes in form of different abnormal flow patterns in colour doppler,to decide time of delivery, mode of delivery and Neonatal outcomes in terms of : APGAR score, Birth weight, duration of NICU stay. Methods: A prospective observational study of n = 350 high‑risk singleton pregnancies (>32 weeks ) underwent systematic Doppler evaluation of uterine, umbilical, and middle cerebral arteries. Measured indices included resistance index (RI), pulsatility index (PI), and systolic/diastolic (S/D) ratio. Doppler findings were classified as normal or abnormal based on established cutoffs for each vessel. Outcomes tracked included mode of delivery, gestational age at birth, birth weight, Apgar scores, NICU admissions, maternal complications (e.g. preeclampsia escalation), and perinatal morbidity/mortality Results: ● Umbilical artery PI > 1.5 showed 80% sensitivity and 88% specificity, observed in 25% of cases; linked to growth restriction, preterm birth, and NICU admissions. ● Uterine artery RI > 0.55, seen in 28% of pregnancies, had moderate sensitivity (75%) and high specificity (82%), and correlated with PIH, IUGR, and fetal distress. ● MCA PI < 1.2, seen in 20.6%, indicated the brain‑sparing phenomenon, with 72% sensitivity and 85% specificity. ● The most severe abnormality—A/REDF in the umbilical artery—occurred in 10% of cases and significantly predicted severe IUGR and perinatal death. ● Abnormal Doppler findings correlated with a 60% cesarean rate, >55% NICU admissions, 40% low birth weight, and 44.9% preterm deliveries. Conclusions: Third‑trimester colour Doppler assessment offers a valuable, noninvasive window into fetomaternal well‑being in high‑risk pregnancies. Abnormal Doppler parameters are strongly predictive of adverse fetomaternal outcomes, Integrating these indices into clinical practice enables timely interventions, optimizes delivery planning,and may significantly reduce perinatal morbidity and mortality.