Significance of Uterine Artery Doppler Velocimetry During Midtrimester in Chronic Hypertensive Patients

Yoon, H J; Park, Y W; Cho, J S; Kang, S R; Lee, Y H; Yoo, Y K; Kim, J U

Abstract

PURPOSE: The purpose of our study is to assess the predictive ability of Doppler velocimetry of uterine circulation during midtrimester in selected group of chronic hypertensive pregnant women to predict the poor perinatal outcomes.
METHODS
We studied 104 cases of chronic hypertensive pregnant women taken Doppler ultrasonography during 24-28 weeks of gestation from September 1989 to June 1998. We measured systolic/diastolic[S/D] ratio and early diastolic notch of uterine artery. We defined that the groups showing S/D ratio was greater than 2.6 or early diastolic notch was present are abnormal, and the others were normal.
RESULTS
The perinatal outcomes of the abnormal Doppler group were more poor than that of normal Doppler group in respect to intrauterine growth restriction, fetal distress, perinatal death and developing pregnancy-aggravated hypertension[26.3% vs. 14.9%, 29.8% vs. 19.2%, 14.0% vs. 0%, 24.6% vs. 10.6% respectively]. And the sensitivity, specificity, positive predictive value and negative predictive value of uterine artery S/D ratio and diastolic notch for predicting poor perinatal outcome were 75.4%, 61.7%, 70.5% and 67.4%.
CONCLUSION
We can suggest that the Doppler flow velocity waveforms of the uterine artery during midtrimester are useful to predict the pregnancy outcomes and to make a better treatment protocols for patients with chronic hypertension.