Prospective evaluation of uterine artery flow velocity waveforms at 12-14 and 22-24 weeks of gestation in relation to pregnancy outcome and birth weight.
OBJECTIVE
Uterine artery flow velocity was prospectively assessed using Doppler ultrasound at 12-14 and 22-24 weeks of gestation in the prediction of subsequent complications related to uteroplacental insufficiency: preeclampsia, pregnancy-induced hypertension, fetal growth restriction, fetal death and placental abruption, and to elucidate its relationship with birth weight.


METHODS
Uterine artery Doppler assessment was obtained during routine ultrasound screening in 263 unselected women. Flow velocity waveforms were coded according to the number of notches present at each scanning, respectively: none (0, 0), uni-/bilateral notches that disappeared (1, 0) or (2, 0), uni-/bilateral notches that persisted unilaterally (1, 1) or (2, 1), and persistent bilateral notches (2, 2).


RESULTS
Complete outcome data was obtained for 243 (92.4%) women. Of these women, 55 (22.6%) and 84 (34.6%) women had uni- and bilateral notches, respectively, at 12-14 weeks' gestation; 14 (5.8%) and 21 (8.6%) patients had uni- and bilateral notches, respectively, at 22-24 weeks' gestation. Analysis of complication rates for the four groups showed that they increased with notch persistence (5.7, 13.5, 57.1 and 76.2%), while the corresponding mean birth weight declined (3,273, 3,180, 2,698 and 2,418 g).


CONCLUSIONS
The absence or early disappearance of uterine artery notches is associated with fewer complications related to uteroplacental insufficiency and normal birth weight, whereas their late and partial disappearance or bilateral persistence tends to compromise the prognosis.
Carbillon
L
L
Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Paris, Hôpital Jean-Verdier, Université de Paris 13, Bondy, France. lionel.carbillon@jvr.ap-hop-paris.fr
Uzan
M
M
Largillière
C
C
Perrot
N
N
Tigaizin
A
A
Paries
J
J
Pharizien
I
I
Uzan
S
S
D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies; D018608:Ultrasonography, Doppler / Q000706:statistics & numerical data; D014599:Uterus / Q000098:blood supply*