Are ‘Notched’ Uterine Arterial Waveforms of Prognostic Value for Hypertensive and Growth Disorders of Pregnancy?

Mires, Gary; Christie, A.D.; Leslie, Joanne; Lowe, Elaine; Patel, Naren; Howie, P. W.

doi:10.1159/000264216

Cited by 10 publications

(2 citation statements)

References 11 publications

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“…Although the presence of a notch is regarded to be 'easily recognizable' [36] , the subjectivity of the assessment is also well known [33,43,[47][48][49][50] . It is not clear when a postsystolic nadir is regarded as a notch, in particular for 'flat' notches, which complicates the comparison of publications.…”

Section: Discussionmentioning

confidence: 99%

Doppler Sonography of Uterine Arteries at 20–23 Weeks: Depth of Notch Gives Information on Probability of Adverse Pregnancy Outcome and Degree of Fetal Growth Restriction in a Low-Risk Population

Becker¹,

Vonk²

2010

Fetal Diagn Ther

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Objective: Our purpose was to assess the relation between the depth of notch in the uterine arteries at 20–23 weeks and the incidence and severity of subsequent pregnancy complications. Methods: The Notch Index (NI) was defined as (C – D)/C, with C = postsystolic zenith and D = postsystolic nadir. For evaluation, the mean NI of the two uterine arteries was determined. Adverse pregnancy outcome was defined as presence of SGA ≤5th percentile, pre-eclampsia, preterm delivery <33 weeks, placental abruption or intrauterine or neonatal death. Women who received preventive treatment (Aspirin or low-molecular heparin) were excluded. Results: A notch was present in 957 of 15,888 singleton pregnancies (6.0%; unilateral = 4.37%, bilateral = 1.66%). The incidence of adverse pregnancy outcome was 5.3%; it increased from 4.6% for women without notch to 41.8% for those with a mean NI ≧0.2 and higher. Moreover, higher mean NI values tended to be associated with lower birth weight. In addition to the maternal age, parity, mean Pulsatility Index and presence of notch, the depth of notch made an additional significant contribution to the assessment of the probability of adverse pregnancy outcome. Conclusion: Besides the classic parameters such as maternal age, history of adverse pregnancy outcome, parity, impedance and the presence of notch, also the depth of notch seems to be valuable in the assessment of adverse pregnancy outcome risk. Especially in cases where very high or very low values of NI are measured, quantification of the depth of notch may give more information than the description of the presence of notch alone. This might be of value for future multivariate models for risk assessment of adverse pregnancy outcome.

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Section: Discussionmentioning

confidence: 99%

Doppler Sonography of Uterine Arteries at 20–23 Weeks: Depth of Notch Gives Information on Probability of Adverse Pregnancy Outcome and Degree of Fetal Growth Restriction in a Low-Risk Population

Becker¹,

Vonk²

2010

Fetal Diagn Ther

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“…For specific conditions, earlier timing of measurements may be considered. 19 The main objective in constituting fetomaternal Doppler sonographic nomograms is to improve perinatal outcome in high risk pregnancies. Curves presented below depict normal fetal and maternal Doppler sonographic values, and can be used in routine practice.…”

Section: Dependency Of Doppler Flow Velocity Waveforms On Gestational Agementioning

confidence: 99%

Doppler Sonography in Obstetrics

Ertan¹,

Taniverdi²

2013

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Doppler sonographic applications in pregnancy are the widely accepted functional methods of evaluating fetal wellbeing. Flow velocity waveforms provide important information from the early stages of pregnancy to term. Doppler ultrasound is a noninvasive technique whereby the movement of blood is studied by detecting the change in frequency of reflected sound. This method became an important tool for qualifying pregnancies in risk. Information obtained with Doppler sonography helps obstetricians managing patients in situations like pregnancies complicated by intrauterine growth restriction (IUGR), rhesus alloimmunization, multiple pregnancies and anamnestic risk factors. Examination of the uteroplacental and fetomaternal circulation by Doppler sonography in the early second trimester helps predicting pregnancy complications like preeclampsia, IUGR and perinatal death. This chapter aims to discuss Doppler sonographic examinations in modern obstetrics. To date, randomized controlled trials were able to establish important clinical value of Doppler velocimetry in obstetrics to improve perinatal outcome in highrisk situations. How to cite this article Ertan AK, Taniverdi HA. Doppler Sonography in Obstetrics. Donald School J Ultrasound Obstet Gynecol 2013;7(2):128-148.

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Hypertension

Redman¹

2002

Medical Disorders in Obstetric Practice

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Are ‘Notched’ Uterine Arterial Waveforms of Prognostic Value for Hypertensive and Growth Disorders of Pregnancy?

Cited by 10 publications

References 11 publications

Doppler Sonography of Uterine Arteries at 20–23 Weeks: Depth of Notch Gives Information on Probability of Adverse Pregnancy Outcome and Degree of Fetal Growth Restriction in a Low-Risk Population

Doppler Sonography of Uterine Arteries at 20–23 Weeks: Depth of Notch Gives Information on Probability of Adverse Pregnancy Outcome and Degree of Fetal Growth Restriction in a Low-Risk Population

Doppler Sonography in Obstetrics

Hypertension

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