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Doppler ultrasound waveform indices in hypertensive pregnants
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Doppler ultrasound waveform indices in hypertensive pregnants 0. Panina,
S. Kalashnikov
and L. Sichinava
Department of Obstetrics and Gynaecology, 2nd Medical Institute of Moscow, Moscow, U.S.S.R.
Blood flow velocity waveforms from the umbilical artery, descending aorta and uterine artery were recorded from 78 patients with pregnancy associated hypertension (PAH). Thirty-five normal pregnancies were also studied. The systolic/ diastolic ratio (S/D), pulsatility index (PI) and resistance index (RI) were calculated. Studies were performed from 28 weeks to term. Measures of outcome were 5-min Apgar scores, birthweight gestational age, perinatal mortality in relation to fetal distress during labor and the duration of neonatal intensive care. The results suggested significant changes depending on the severity of PAH and were independent of gestational age. In 25% of mild forms of the disease abnormality of the umbilical and descending wave forms were seen in 17% of cases. No abnormal uterine artery wave forms
were found in these patients. The frequency and degree of abnormal findings of blood flow velocity waveforms increased with the severity of the disease, thus S/D, RI, PI in increased umbilical artery to 4.0, 0.75 and 1.6, respectively. In most severe cases, especially associated with IUGR, abnormal values of all these three ratios were recorded not only from the umbilical artery, but from the aorta and the uterine artery as well, less significant in the latter, showing an increased vascular resistance in the fetal body and placenta. We conclude that in hypertensive patients Doppler waveform studies in umbilical artery, aorta and uterine artery predict the most compromised fetus and in combination with other investigations, indicate the need for preterm delivery.
Doppler ultrasound waveform indices in hypertensive pregnants 0. Panina,
S. Kalashnikov
and L. Sichinava
Department of Obstetrics and Gynaecology, 2nd Medical Institute of Moscow, Moscow, U.S.S.R.
Blood flow velocity waveforms from the umbilical artery, descending aorta and uterine artery were recorded from 78 patients with pregnancy associated hypertension (PAH). Thirty-five normal pregnancies were also studied. The systolic/ diastolic ratio (S/D), pulsatility index (PI) and resistance index (RI) were calculated. Studies were performed from 28 weeks to term. Measures of outcome were 5-min Apgar scores, birthweight gestational age, perinatal mortality in relation to fetal distress during labor and the duration of neonatal intensive care. The results suggested significant changes depending on the severity of PAH and were independent of gestational age. In 25% of mild forms of the disease abnormality of the umbilical and descending wave forms were seen in 17% of cases. No abnormal uterine artery wave forms
were found in these patients. The frequency and degree of abnormal findings of blood flow velocity waveforms increased with the severity of the disease, thus S/D, RI, PI in increased umbilical artery to 4.0, 0.75 and 1.6, respectively. In most severe cases, especially associated with IUGR, abnormal values of all these three ratios were recorded not only from the umbilical artery, but from the aorta and the uterine artery as well, less significant in the latter, showing an increased vascular resistance in the fetal body and placenta. We conclude that in hypertensive patients Doppler waveform studies in umbilical artery, aorta and uterine artery predict the most compromised fetus and in combination with other investigations, indicate the need for preterm delivery.