[Prediction of fetal wellbeing with Doppler flowmetric profile in pregnant hypertensive women].
In order to evaluate the diagnostic accuracy of the Doppler ultrasonography profile in the assessment of fetal wellbeing in hypertensive pregnancies, 171 women at 36-42 week's gestation were included. A Doppler color ultrasound scanning was made and the score of the Doppler ultrasonography profile were correlated with the neonatal outcome, with one minute Apgar's score or admission to neonatal intensive care unit as main outcome. The Doppler ultrasonography profile includes: umbilical artery Doppler flow velocity waveforms, amniotic fluid volume, fetal movements, placental grading and fetal growth pattern. In 145 cases (84.7%) had gestational hypertension without proteinuria, 22 patients (12.9%) had chronic hypertension and only in 4 cases (2.4%) preeclampsia was found. In 101 patients (59%) a cesarean section was made, 66 cases delivered normally and 4 (2.4%) patients had complicated vaginal delivery. Scores of diagnostic tests were: sensitivity 44%, specificity 99%, positive predictive value 80% and negative predictive value 97%, with an average accuracy of 71.5%. The multiple logistic regression analysis with 5 parameters of the Doppler ultrasonography profile had a determination coefficient (R2 = 0.15125) P < 0.01, and umbilical artery Doppler flow velocity waveforms had a regression coefficient--31.3959 (P < 0.05). It was concluded that the Doppler ultrasonography profile is a test with high predictive values in assessing fetal wellbeing in hypertensive pregnancies and the umbilical artery Doppler flow velocity alone is a significant variable in the multiple logistic regression analysis.
Romero Gutiérrez
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Unidad de Investigación en Epidemiología Clínica, Hospital de Gineco-Pediatría No. 48 León, Guanajuato, Instituto Mexicano del Seguro Social.
Aguilar Barajas
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Chávez Curiel
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Ponce Ponce de León
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D000293:Adolescent; D000328:Adult; D005260:Female; D005323:Fetal Monitoring / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012212:Rheology / Q000379:methods; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal