Doppler ultrasonography in early pregnancy does not predict adverse pregnancy outcome

Abstract

A transvaginal color and pulsed Doppler study was performed on 330 pregnancies at 7-16 weeks of gestation. Blood flow velocity waveforms were recorded from the main uterine arteries and their branches (arcuate and trophoblastic vessels) and from the umbilical arteries. The systolic/diastolic velocity ratio and the pulsatility index were calculated as indices of vascular resistance, respectively, at uterine and umbilical levels. A total of 282 patients had an uneventful pregnancy outcome, 19 developed an early pregnancy failure (missed abortion, n = 8; anembryonic pregnancy, n = 11) and 29 developed later complications such us hypertension (n = 10), fetal growth retardation (n = 13) or both n = 6). In normal pregnancies, Doppler-measured vascular resistances significantly decreased with advancing gestation at the level of both uterine and umbilical circulations. When the Doppler indices of the patients with early pregnancy failure or with later complications were compared to those of normal pregnancies, no evident differences were found in either of the vascular districts considered. However, in the patients who developed hypertension and/or fetal growth retardation, abnormal velocity waveforms were frequently present in uterine and umbilical arteries during second- or third-trimester examinations. Our results suggest a limited clinical value of Doppler velocimetry in early pregnancy.