Is Doppler Velocimetry Useful for the Prediction of Uteroplacental Insufficiency?

Lim, Young Koo; Kim, Kyung Soo; Choi, Hyung Min; Kim, Tae Yoon; Cho, Jae Sung; Park, Yong Won

Abstract

This study was designed to investigate a possible role for Doppler velocimetry as apredictor of uteroplacental insufficiency with fetal heart rate(FHR) tracing. From January1994 to through May 1996, we studied 419 high risk pregnant women who underwent Dopplervelocimetry within 1 week of intrapartum cardiotocogram or contraction stress test(CST) after 30 gestational weeks. The presence of a diastolic notch in uterine artery,elevated systolic/diastolic(S/D) ratios in umbilical artery(more than 3.0), or in uterine artery(more than 2.6) were considered abnormal. All of the 419 subjects were performed intrapartumcardiotocogram or CST within 1 week after Doppler veocimetry. Seventeen caseswere associated with persistent late deceleration or positive CST. The sensitivity, specificity,positive predictive value, negative predictive value, and relative risk of umbilical arteryS/D ratio for predicting abnormal FHR tracing were 23.5%(4/17), 89.3%(359/402), 8.5%(4/47), 96.5%(359/372), and 0.97. those of uterine artery S/D ratio and diastolic notch were29.4%(5/17), 92.5%(372/402), 14.3%(5/35), 96.9%(372/384), 1.35 and 35.3%(6/17), 90.3%(363/402), 13.3%(6/45), 97.6%(363/374), 3.88 respectively. The presence of uterine arterydiastolic notch in Doppler velocimetry seems to be a better predictor for abnormal FHRtracing after 30 weeks gestation than are S/D ratios in umbilical or uterine arteries.In conclusion, we can suggest that the presence of diastolic notch in uterine arteryDoppler velocimetry might be useful to predict the uteroplacental insufficiency after 30gestational weeks.