Uterine and umbilical artery velocimetry in pre-eclampsia.
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.


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.
Department of Obstetrics and Gynecology, University of Lund, University Hospital MAS, Malmö, Sweden.
K
K
van Asselt
S
S
Gudmundsson
P
P
Lindqvist
K
K
Marsal
D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011673:Pulsatile Flow; D018608:Ultrasonography, Doppler; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging*