Correlation of third-trimester Doppler abnormalities and amniotic fluid volume with preterm birth in pregnant women of Southern Bihar.

Zahid Salim  Ahmad; Shamim  Ahmad; Saima  Shreen; Zeba  Nahid; Gaurav  Prakash

doi:10.51168/sjhrafrica.v5i11.2243

Authors

Zahid Salim Ahmad Assistant Professor, Department of Radiodiagnosis, Narayan Medical College and Hospital, Sasaram, Bihar, India
Shamim Ahmad Professor and Head of the Department, Department of Radiodiagnosis, Narayan Medical College and Hospital, Sasaram, Bihar, India
Saima Shreen Junior Resident, Department of Obstetrics and Gynaecology, Eras Lucknow Medical college and Hospital , Lucknow, Uttar Pradesh, India
Zeba Nahid junior resident, Department of Pathology, Narayan Medical College and Hospital ,Sasaram , Bihar, India
Gaurav Prakash Senior Resident, Department of Radiodiagnosis, Narayan Medical college and Hospital , Sasaram, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i11.2243

Keywords:

Preterm birth, Doppler velocimetry, Amniotic fluid volume, Oligohydramnios, Third-trimester ultrasound

Abstract

Background
Preterm birth remains a major contributor to neonatal morbidity and mortality worldwide. Early detection of pregnancies at risk is critical, especially in resource-limited regions. Third-trimester ultrasonography—specifically Doppler velocimetry and amniotic fluid volume (AFV) assessment—offers a non-invasive way to identify compromised fetal environments that may precipitate preterm labor.

Aim: To evaluate the association between abnormal Doppler findings and abnormal amniotic fluid volume in the third trimester with preterm birth among pregnant women in Southern Bihar.

Methods
A prospective observational study was conducted over 11 months at Narayan Medical College and Hospital, Sasaram, Bihar, involving 115 pregnant women in their third trimester. Participants underwent detailed Doppler velocimetry and AFV assessment. Data on maternal characteristics, ultrasonographic findings, and pregnancy outcomes were recorded. Statistical analysis was performed using SPSS version 23.0, and associations were analyzed using chi-square tests, with p < 0.05 considered statistically significant.

Results
Among the 115 participants, 28.7% exhibited abnormal Doppler findings, and 21.7% had abnormal AFV (18.3% oligohydramnios, 3.5% polyhydramnios). Preterm birth occurred in 27% of the study population. Preterm delivery was significantly higher in women with abnormal Doppler (57.6%) compared with those with normal Doppler (14.6%) (p < 0.001). Similarly, preterm birth occurred in 57.1% of women with oligohydramnios and 60% with polyhydramnios compared with 15.7% with normal AFV (p < 0.001).

Conclusion
Abnormal third-trimester Doppler and AFV findings are strongly associated with preterm birth. Integrating these parameters into routine antenatal care could improve early risk stratification and allow timely interventions.

Recommendations
We recommend incorporating combined Doppler and AFV screening into third-trimester antenatal protocols, particularly for high-risk pregnancies. Enhanced surveillance, early referral, and delivery planning at equipped centers may reduce preterm birth complications and improve neonatal outcomes. Further multicenter studies with larger cohorts are advised to validate these findings.

References

Zijl F, Andriessen MPJ, Mulik V, Wladimiroff JW, van Doormaal CJ, Ross MG, et al. The predictive capacity of uterine artery Doppler for preterm birth-A cohort study. Acta Obstet Gynecol Scand. 2020;99(5):612-21.

https://doi.org/10.1111/aogs.13770 PMid:31715024 PMCid:PMC7155020

Sawant AA, Wankhede S, Thakare S, Narayan GN, Saha I, Vernekar A, et al. Maternal and perinatal outcomes in oligohydramnios: a cross-sectional analysis of pregnancies between 28 to 42 weeks of gestation. Cureus. 2025;17(2):e79232. https://doi.org/10.7759/cureus.79232

Zijl F, Andriessen MPJ, Mulik V, Wladimiroff JW, van Doormaal CJ, Ross MG, et al. The predictive capacity of uterine artery Doppler for preterm birth-A cohort study. Acta Obstet Gynecol Scand. 2020;99(5):612-21.

https://doi.org/10.1111/aogs.13770 PMid:31715024 PMCid:PMC7155020

Morales-Roselló J, Khalil A, Hervás-Marín D, Perales-Marín A, García-Burguillo A, Khalil A, et al. Third trimester uterine artery Doppler for prediction of adverse perinatal outcomes: A systematic review. Obstet Gynecol Surv. 2022;77(8):488-500.

Manzaneres S, Martí G, Canals J, Meler E, Serra B, Ferrer Q, et al. Perinatal outcomes in pregnancies with oligohydramnios and polyhydramnios: a multicenter cohort study. Reprod Health. 2020;17(1):33-41.

Goldenberg RL, Nathan RO, Swanson D, Saleem S, Ali SA, McClure EM, et al. Oligohydramnios: A prospective study of fetal, neonatal and maternal outcomes in low- and middle-income countries. Reprod Health. 2020;17(1):24-31. https://doi.org/10.1186/s12978-020-0854-y PMid:32000798 PMCid:PMC6993413

Gupta A, Choorakuttil RM, Nirmalan PK. The association of abnormal Doppler and abnormal amniotic fluid volume in the third trimester of pregnancy with preterm birth in pregnant women in Agra, India. Indian J Radiol Imaging. 2023;33(3):315-20. https://doi.org/10.1055/s-0043-1764465 PMid:37362367 PMCid:PMC10289862

Dall'Asta A, Sglavo G, Frusca T, et al. Maternal cardiovascular function and uterine artery Doppler in predicting preterm birth and fetal growth restriction. Prenat Diagn. 2020;40:125-131.

Gandhi M, Patel R, Desai V, et al. Perinatal outcomes in pregnancies with abnormal Doppler velocimetry and oligohydramnios. J Matern Fetal Neonatal Med. 2020;33:45-52.

Mitra S, Gupta P, Rani R, et al. Role of umbilical artery Doppler ultrasonography in high-risk pregnancies: correlation with preterm birth. Int J Gynaecol Obstet. 2019;145:210-218.

Jain N, Kumar V, Mehta S, et al. Fetal outcome in pregnancies complicated by abnormal amniotic fluid volume. J Obstet Gynaecol Res. 2019;45:78-85.

Sharma P, Singh R, Chawla D, et al. Doppler indices and amniotic fluid index in predicting preterm birth: a comparative study. Arch Gynecol Obstet. 2018;298:33-40.