Maternal and fetal artery Doppler findings in women with chronic hypertension who subsequently develop superimposed pre-eclampsia.
OBJECTIVE
To carry out a prospective study of Doppler velocimetry of the fetomaternal circulation in women with chronic hypertension, to evaluate whether the subsequent development of superimposed pre-eclampsia can be predicted.


METHODS
Serial Doppler studies of the maternal uterine and renal arteries, and fetal middle cerebral and umbilical arteries, were performed at 16-20 and at 28-32 weeks' gestation in 56 women with chronic hypertension. Pulsatility indices were compared using the Wilcoxon rank sum method. A p value of < 0.05 was considered significant.


RESULTS
Uterine artery impedance was significantly elevated as early as 16-20 and at 28-32 weeks' gestation, while the cerebroplacental ratio was lower at 28-32 weeks' gestation, in the 14 women who developed superimposed pre-eclampsia. The maternal renal artery impedance remained constant throughout gestation, regardless of the development of pre-eclampsia.


CONCLUSIONS
Uterine artery Doppler velocimetry at 16-20 and at 28-32 weeks' gestation showing increased impedance is predictive for the development of superimposed pre-eclampsia in women with chronic hypertension. The cerebroplacental ratio suggested early fetal brain sparing at 28-32 weeks' gestation in these women.
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8896, USA.
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Zeeman
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McIntire
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Twickler
D000328:Adult; D002908:Chronic Disease; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007083:Iliac Artery / Q000000981:diagnostic imaging; D011225:Pre-Eclampsia / Q000209:etiology / Q000503:physiopathology*; D011247:Pregnancy; D011446:Prospective Studies; D012077:Renal Artery / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*