 Good morning, respected teachers, myself, Dr. Dhruv Indosi, second year resident at GCS Medical College, guided by Dr. Nikunj Desai, professor at GCS Medical College. So my topic is the role of a professor in predicting fatal outcome in pregnancy induced hypertension. Introduction. Hypertensive disorder is one of the most common complications that affect the human pregnancy. It is one of the leading causes of the material and fatal morbidity and mortality. Cardopathy techniques have provided repetitive, non-invasive, more dynamic monitoring in pregnancy. Also, it is more sensitive and detected early fatal compromise and aids in the guiding and making the decisions regarding the appropriate timing of the delivery. My aims and objective is to evaluate the role of color Doppler in predicting the fatal outcome in the case of the pregnancy induced hypertension in second trimester. Role of uterine, umbilical, MCA, arteries, velocity matter for early recognition of the high risk pregnancies. An analysis of the abnormal velocity waveforms of umbilical, uterine, MCA, and ductus venosis in second trimester of the pregnancy to predict the fatal outcome. I have taken 50 patients for the second at 60 patients with hypertension in second trimester of the pregnancy and at the radiology department. The criteria for the abnormal indices, the abnormal uterine entry, we can see there is a persistent diastolic notch every 22 weeks, elevated PI. RI is greater than 0.58 and SD ratio is greater than 2.6. Now abnormal umbilical. For umbilical, decreased absent or reversed diastolic flow, elevated PI, RI or SD ratio, abnormal umbilical. Now, criteria from abnormal MCA. For MCA, in early stages of the fetal hypoxia, we can see there is an increase in MCA PSP. In compromised state, decreased PI. In severe cases, PI tends to be raised, reflects the development of the brain edema. And in absent and reversal flow, there is an omniacin. In abnormal ductus venosis, in early stages, we can see that it decreased A wave. And in the later, there is absent completely or reversed A wave. So the first case is a 27 year old female gravita 2 with history of hypertension, previous pregnancy at 24 weeks of this station comes toward the ULZ. We can see there is a persistent diastolic notch in the uterine artery. But the umbilical and MCA is normal, normal umbilical PI RI and normal MCA. The second case, 23 year old female primate gravita at the 26th week of gestation with complaint of hypertension. BP is 160 by 100 mmHg. The umbilical PI is raised, it's about 2.05. However, the MCA's, MCA PI is normal. So, it's suggestive of the utroplacental insufficiency. The third case is 25 year old secondary gravita at 28 weeks of gestation with a complaint of decreased perception of fetal movement. Her BP is 180 by 105 mmHg. We can see there is abnormal umbilical PI. It's upon 2.35 and abnormal MCA PI also. It's about 1.34. And on ductus venosis, we can see it is completely normal. So, it is due to brain spanning effect. The blood from the whole body goes to the brain. So, the ductus venosis is completely normal. On the fourth case, that is a 26 year old third gravita at 25 weeks of gestation with severe hypertension. Her BP is 210 by 110 and decreased fetal movement. On umbilical, we can see there is a reversal of the umbilical flow. And on the MCA, it is also abnormal MCA. On ductus venosis, we can see there is a reversal of AVV. So, it's indicated the need of immediate intervention. Observation on age distribution and inferiority. 75% of the patient belong to 21 to 20 age group and maximum patients 48% were primary fetal. Distribution cases on the basis of the Doppler indices. The uterine and umbilical indices were found to abnormal in the most of the patients where are going to ductus venosis was largely normal. The main is umbilical and uterine artery. On the fetal outcome, with the normal Dopplers on the umbilical MCA and the uterine, we can see there is a normal fetal outcome in 85% of the cases. However, if any of the indices is abnormal, any of the one, it is approximately 61% abnormal outcome for the fetus. The result, the sensitivity sensitivity of the umbilical is on a higher side about 86%. And however, the specificity of MCA and ductus venosis is higher. The sensitivity of umbilical artery indices is higher for the prediction of the abnormal fetal outcome. The specificity of MCA and ductus venosis is higher for the prediction of the abnormal fetal outcome. This is uterine, this umbilical, it is higher. And in the specificity, we can see that ductus venosis MCA is on a higher side. The conclusion, the Doppler artery is very sensitive index for the fetal well-being and gumptomize in PIH. Average gestation age for the delivery in the patient with the abnormal indices was 34 weeks and the patient with the normal Doppler indices has the full term normal delivery. Why is fetal seen in absent reversed or diastolic flow in umbilical artery? Epson reversed PI over MCA and in a reversal of A wave or absent A wave of ductus venosis. So, here my topic is over. Thank you for listening.