Umbilical artery Doppler ultrasound predicts low birth weight and fetal death in hypertensive pregnancies.

BACKGROUND

Doppler ultrasound is nowadays common in the management of pregnancies complicated with hypertension, as an indirect assessment of fetal well-being. However, the value of abnormal umbilical artery Doppler results in predicting poor fetal outcome in hypertensive pregnancies has been studied in only a small number of patients. We designed a study to investigate the relation between abnormal umbilical artery Doppler velocimetry and fetal outcome in hypertensive pregnancies.

DESIGN

A prospective observational study over a 2-year period was performed at the Hospital Clinic, University of Barcelona. Pulsed Doppler examinations of the umbilical artery were performed in one hundred and seventy-two hypertensive pregnant women. The physicians managing the case were not aware of the Doppler results. The incidence of low birth weight and fetal death were considered as the main outcome measures.

RESULTS

When low birth weight was used as an end-point, abnormal resistance index showed a high specificity (95.16%), positive predictive value (83.33%), and negative predictive value (86.76%). Sensitivity was 62.5%. The absence of end-diastolic velocity predicted low birth weight in 100% of pregnancies and fetal death in 66.66%. All stillbirths had absence of end-diastolic velocity (sensitivity 100%).

CONCLUSION

This study demonstrates that umbilical artery Doppler velocimetry is a useful tool to assess fetal well being in hypertensive pregnancies.