Uterine artery velocimetry in patients with gestational hypertension.
OBJECTIVE
To evaluate whether abnormal uterine artery velocimetry in patients with pregnancy-induced hypertension is more predictive of the outcome of pregnancy than the presence of proteinuria and the severity of hypertension.


METHODS
A retrospective study was conducted on 344 hypertensive pregnant women who underwent uterine artery Doppler investigation. Patients were classified as either preeclamptic or with gestational hypertension at follow-up 2 months after delivery. Pregnancy outcomes of patients with preeclampsia and gestational hypertension were correlated to uterine artery velocimetry. A further analysis was done dividing patients into mild and severe groups.


RESULTS
An abnormal uterine Doppler was related to a significantly earlier week of delivery (32.5 versus 35.3 in preeclampsia, 33.6 versus 38.1 in gestational hypertension), a lower mean birth weight (1494 g versus 2320 g in preeclampsia, 1690 g versus 2848 g in gestational hypertension), and a higher number of growth-restricted fetuses (70% versus 23% in preeclampsia, 75% versus 20% in gestational hypertension). In both mild and severe hypertensive groups, abnormal uterine velocimetry was associated with a worse pregnancy outcome (delivery at week 33.1, versus 37.9 in the mild group; 32.7 versus 37.3 in the severe group; birth weight 1574 g versus 2741 g in the mild group; 1539 g versus 2742 g in the severe group). A multivariable analysis of the presence of proteinuria, severity of hypertension, and uterine Doppler revealed that only an abnormal uterine Doppler was significantly related to adverse perinatal outcome (P <.001).


CONCLUSIONS
Abnormal uterine Doppler was the variable that was more frequently associated with adverse pregnancy outcome.
Frusca
T
T
Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy. tifrusca@tin.it
Soregaroli
M
M
Platto
C
C
Enterri
L
L
Lojacono
A
A
Valcamonico
A
A
D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011256:Pregnancy Outcome; D011336:Probability; D012189:Retrospective Studies; D012212:Rheology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging*