[The usefulness of uterine artery doppler velocimetry in high risk pregnancy diagnostic (PIH and/or IUGR)].

OBJECTIVES

High risk pregnancy was defined as developing of pregnancy induced hypertension or/and growth retardation in the course of gestation.

DESIGN

The main aim of the study is to analyze the usefulness of uterine artery doppler velocimetry in high risk pregnancy diagnostic.

MATERIALS AND METHODS

610 single pregnancies were included in the study. First group of normal pregnancies where -530 single normal pregnancies between 19 and 39 gestation weeks. S/D, RI & PI in both uterine arteries were assessed. There were assessed flow velocity waveforms also for detection of notches. At the next stage an examined group with 80 pregnant women was formed where in the course of gestation pregnancy induced hypertension and/or fetal growth retardation. 24 hour monitoring of the blood pressure in the examined group was performed. Obtained data from both groups was calculated and statistically analyzed.

RESULTS

Mean values for flow velocity waveform indices were estimated for both groups: controls S/D 2,35 (SD 0,61), RI 0,56 (SD 0,11), PI 0,96 (SD 0,32), examined group S/D 2,99 (SD 1,16), RI 0,63 (SD 0,12), PI 1,26 (SD 0,51). There is significant difference between values for all flow parameters p < 0,001. In the control group we observed notches in 11,8% of all women and in the examined (hypertension and/or growth restriction) group in 81,3% (p<0,001). The sensitivity is 81,3% and specificity 88,2%. MoMRIs for both uterine arteries were calculated to compare data from control and examined group. In the examined group 41,3% RI results were above calculated MoM and there is significant difference between both groups (p <0,001). The sensitivity is 41,3% and specificity 89,5%. In the group of the hypertensive pregnant women where mean systolic blood pressure in 24 hour monitoring was above 130 mm Hg we observed notches in 61,1% of flow velocity waveforms in uterine arteries. In the group of normal pregnancies there were 11,8% notches and there is significant difference between both groups (p<0,001).

CONCLUSIONS

The uterine artery velocimetry values of S/D, RI, PI decrease with the progression of gestation. There are no significant differences between right and left uterine artery doppler velocimetry. There are significant differences for values and percentage of notches in both groups. Extremely high rate of notches is observed in the group with most elevated blood pressure (daily mean value over 130mm Hg). It is possible to calculate obstetrical risk assessing values for blood flow in uterine arteries in pregnancy. It can be helpful to estimate methods detecting elevated risk for hypertension and/or growth retardation in pregnancy.