Doppler sonography of uterine arteries at 20–23 weeks: risk assessment of adverse pregnancy outcome by quantification of impedance and notch
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R. Becker
Abstract
Objective: To assess the diagnostic value of Doppler sonography of the uterine arteries (DSUA) at 20–23 gestational weeks as screening procedure in a low risk population
Patients and methods: The study group consisted of 7508 singleton low-risk pregnancies. Doppler sonography of both uterine arteries was performed as routine part of anomaly scan. Impedance of both uterine arteries was registered using the mean PI of the two uterine arteries. In case of notch,“Notch-Index” was defined as (C-D)/C with D = post-systolic nadir and C = following zenith of the waveform. Outcome variables were placental abruption, pre-eclampsia, intrauterine growth retardation, intrauterine/neonatal death and preterm delivery before 32 completed gestational weeks. To discriminate normal and pathological waveform, incidence of adverse pregnancy outcome was related to four different definitions of pathological waveform. To describe the severity of impairment of perfusion, the frequency of adverse pregnancy outcome was related to different classes of impedance.
Results: To find a simple discrimination between normal and pathological uterine perfusion, best diagnostic performance was reached by a definition using a combination of high impedance and notch (no notch and mean PI > P'95 or unilateral notch and mean PI > P'90 or bilateral notch and mean PI > P'50). The prevalence of notch in nulliparae (8.5%) was higher than in parae (4.7%) and decreased with increasing gestational age (20 weeks: 8.6%–23 weeks: 5.4%). We found a clear relation between elevation of impedance, depth of notch and frequency of adverse pregnancy outcome with a frequency of complications varying from 3.2% (mean PI =?0.8, mean NI = 0.1) to 38.4% (mean PI > 2.0, mean NI > 0.1
Conclusion: Doppler sonography of the uterine arteries at 20–23 weeks has the capacity to predict at least a part of severe forms of adverse pregnancy outcome and to assess the probability of complications by quantification of the impairment of the uterine blood
Copyright © 2002 by Walter de Gruyter GmbH & Co. KG
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- Congress Calendar
Articles in the same Issue
- Editorial
- The odds of delivering one, two or three extremely low birth weight (<1000 g) triplet infants: a study of 3288 sets
- Evaluation of a device for objective determination of cervical consistency: A pilot study of devices validity on uterine specimens obtained by total abdominal hysterectomy for benign uterine disease
- Clinical risk factors for deep venous thrombosis in pregnancy and the puerperium
- Waterbirth: water temperature and bathing time mother knows best!
- Anal sphincter injury during vaginal delivery – an argument for cesarean section on request?
- Doppler sonography of uterine arteries at 20–23 weeks: risk assessment of adverse pregnancy outcome by quantification of impedance and notch
- Cadmium concentration in maternal and cord blood and infant birth weight: a study on healthy non-smoking women
- The effects of oral carbohydrate administration on fetal acid base balance
- Labor induction and meconium: in vitro effects of oxytocin, dinoprostone and misoprostol on rat ileum relative to myometrium
- Catch-up growth in fetal malnourished term infants
- Role of surfactant inhibitors in amniotic fluid in respiratory distress syndrome
- Congenital tuberculosis proven by percutaneous liver biopsy: report of a case
- A case of peripartum cardiomyopathy with a transient increase of plasma interleukin-6 concentration occurred following mirror syndrome
- Bilateral cystic adenomatoid lung malformation type III – a rare differential diagnosis of pulmonary hypertension in neonates
- An unexpected case of primary pulmonary hypertension of the neonate (PPHN). Potential role of topical administration of enoxolone
- Urethral catheterization in neonates – how far is too far?
- Congress Calendar
