Fetal umbilical Doppler in a population of 541 high-risk pregnancies: prediction of perinatal mortality and morbidity. Doppler Study Group.
OBJECTIVE
To evaluate the usefulness of systematic umbilical Doppler in the assessment of high-risk pregnancies.


METHODS
In a prospective multicentre study, a group of high-risk pregnancies (intrauterine growth retardation, hypertension during pregnancy, abnormal obstetric history) was systematically studied by Doppler exploration of the fetal umbilical artery between 28 and 34 weeks. All the details of pregnancy development to the first postnatal days were collected and analysed a posteriori.


RESULTS
Three groups were formed according to Doppler results (Index S-D/S) A, index < 90th percentile (n = 458, 84.6%); B, index > or = 90th percentile and diastole over zero (n = 67, 12.4%); C, zero diastole (n = 16, 2.9%). There was a strong correlation between Doppler results and pregnancy development. Group C corresponded to a greatly altered prognosis (hypotrophy, < 3rd percentile in 69%; intrauterine deaths in 9/16). In group B, relative to group A, the prognosis was significantly altered (hypotrophy, 24% versus 6%, P < 0.01; prematurity rate, 25% versus 11%, P < 0.001) but these repercussions were not as severe as in group C.


CONCLUSIONS
In high-risk pregnancies, fetal umbilical artery Doppler study is of interest for prognostic assessment. Normal results should provide temporary reassurance. Abnormal umbilical Doppler indicates that chronic suffering will occur or is onset in at least one-third of cases.
Poulain
P
P
Maternity Department, Rennes Teaching Hospital, France.
Palaric
J C
JC
Paris-Liado
J
J
Jacquemart
F
F
D001783:Blood Flow Velocity; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D009017:Morbidity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D018566:Pregnancy, High-Risk; D011379:Prognosis; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000196:embryology*