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Uterine Doppler evaluation in 12 women with pregnancy‐induced hypertension: correlation with fetal Doppler study and perinatal outcome
Author(s) -
Gómez O.,
Del Río M.,
Martínez J. M.,
Palacio M.,
Puerto B.,
Cararach V.
Publication year - 2001
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2001.abs27-23.x
Subject(s) - medicine , hellp syndrome , ductus venosus , obstetrics , pregnancy , fetus , uterine artery , gestation , gestational age , umbilical artery , gestational hypertension , eclampsia , gynecology , genetics , biology
Classification of hypertensive disorders of pregnancy is problematic due to variable clinical presentation and confusing terminology. Management is based on severity of clinical and laboratory criteria, which, unfortunately, do not select pregnancies that will be delivered because of maternal or fetal indication. Objective: To evaluate whether maternal uterine Doppler evaluation correlates with fetal Doppler study and maternal and perinatal results. Design: Twelve women with pregnancy‐induced hypertension (ISSHP criteria) between 26 and 38 weeks of gestation were divided into two groups based on uterine Doppler examination (presence – group A, or absence – group B, of a bilateral protodiastolic uterine notch) at diagnosis. Results: There were seven patients in group A (four severe and three mild pre‐eclampsia) and five patients in group B (one severe and one mild pre‐eclampsia, two severe gestational hypertension, one Hellp syndrome). The mean gestational age at delivery (weeks gestation), the mean birth weight (grams) and the mean umbilical artery pH in groups A and B were, respectively, 31.1 vs. 36.1, 1256 vs. 2428, and 7.20 vs. 7.25. Doppler evaluation showed statistically significant higher pulsatility index of the right and left uterine artery, as well as in the umbilical artery, in group A vs. group B. Fetal vascular redistribution or a ductus venosus PI >1 were detected only in group A (5/7 and 3/7, respectively), whereas in none of the group B. Indication for delivery was always for fetal risk (four cases) or maternal risk (three cases) among group A, whereas for maternal indication was only in one case of the group B. Comments: We suggest that uterine Doppler examination at the time of diagnosis in patients with hypertensive disorders of pregnancy may help to identify pregnancies at serious maternal and fetal risks better than classical clinical and laboratory criteria.