Uterine and umbilical artery velocimetry in pre-eclampsia

Abstract

Background: The aim of the present study was to evaluate whether Doppler velocimetry of the placental circulation can predict adverse outcome of pregnancies complicated by pre-eclampsia and whether there is a correlation between maternal blood pressure, proteinuria and placental vascular resistance.

Material and methods: One hundred and eight pregnant women with pre-eclampsia were followed and examined by Doppler velocimetry of the uterine arteries. The presence of a notch and the mean pulsatility index (PI) in the two arteries were recorded. The velocity waveforms in umbilical arteries were also evaluated. The Doppler velocimetry results were related to the perinatal outcome, maternal blood pressure and proteinuria.

Results: Abnormal arterial blood velocity waveforms on both sides of the placenta were significantly correlated with a shorter gestational age at delivery, lower birthweight, increased cesarean section rate and more frequent admissions to the neonatal intensive care unit. Bilateral rather than unilateral uterine artery notches were predictive of poor perinatal outcome. The combination of umbilical and uterine artery waveform results was the best predictor of adverse outcome. The uterine artery velocimetry was, however, not related to maternal blood pressure or the degree of proteinuria.

Conclusions: Abnormal velocity waveforms in the uterine and umbilical arteries have clinical significance in pregnancies complicated by pre-eclampsia and predict adverse outcome of pregnancy, especially the fetal growth restriction and need for operative interventions during labor and delivery.