Correlation of Fetal Heart Rate, Uterine Artery Pulsatility Index, Pregnancy Associated Plasma Protein-A and Crown-Rump Length in Pre-eclampsia - a Prospective Cohort Study.

Background The prevalence of pre-eclampsia (PE) as a systemic disease in pregnancy is about 3-5%, but it is still one of the most important causes of maternal and infant mortality worldwide. This study aimed to investigate the association between fetal heart rate (FHR) and uterine artery pulsatility index (UtA-PI) in Doppler. Methods: The current cohort study was carried out on 317 pregnant women with a gestational age of 11 to 13 weeks and six days. Mothers were followed up from the first trimester until the delivery between March 2019 and March 2020. Uterine artery pulsatility index, FHR and ductus venosus pulsatility index (DVPI) were recorded. Finally, the Doppler index of ductus venosus, FHR and other design variables were compared between the two groups with and without preeclampsia. Results: Subjects' mean body mass index (BMI) was 25.31±3.98 kg/m2. The UtA-PI was correlated with Crown rump length (CRL) (r=-0.207, p=0.001), pregnancy associated plasma protein-A (PAPP-A) (r=-0.167, p=0.003), FHR (r=0.14, p=0.011) and uterine artery multiples of the median (UA MoM) (r=0.990, p=0.001), with the last one showing a strong positive correlation with CRL; PAPP-A had a reverse correlation with UA MoM (r=-0.171, p=0.002) and UtA-PI (r=-0.167, p=0.003), while FHR had a poor correlation with UA MoM (r=0.118, p=0.035) and UtA-PI (r=0.142, p=0.011). Conclusions: Uterine artery multiples of the median (UA MoM) was found to have a strong correlation with UtA-PI and, but a reverse correlation with PAPP-A. Intrauterine growth restriction (IUGR) had a significant association with FHR and UtA-PI. These findings imply the necessity of further future follow-up of offspring with a history of increased UtA-PI or maternal PE for cardiac alteration.