Ultrasound prediction of abnormal infant development in hypertensive pregnant women in the second and third trimester

Abstract

The objective was to assess the sensitivities and accuracies of Doppler ultrasound parameters in the second and third trimester of hypertensive pregnancies in determining perinatal outcomes. 1,054 pregnancies were retrospectively categorized into three groups (healthy pregnancies (HP, n = 988), pregnancies of hypertensive women (HypP, n = 30) and high-risk hypertension pregnancies (HRHypP, n = 36), depending on gestational hypertension as well as fetal birth weights and pregnancy outcomes. Systolic/diastolic ratio (S/D), resistance index (RI), pulsatility index (PI) of the bilateral uterine artery, umbilical artery and vein as well as venous flow velocity data were monitored by Doppler ultrasound. At 20–27 and 28–32 gestational weeks, uterine artery PIs and RIs were significantly higher in the HRHypP group than in the HP and HypP patients. At gestational weeks 20–27 and 28–32 left plus right PI data with cut-off values of 2.35 and 1.73 indicated a risk of stillbirth, premature pregnancy termination and a birth weight of less than 2,500 g with sensitivities of 94.4% and 93.1% as well as specificities of 95.2% and 90.1%, respectively.

Doppler Ultrasound of the Umbilical Artery: Clinical Application

“…However, it is the UtA PI that better predicts its future development 100 101 and anticipates adverse outcomes related to the condition. 102 …”

“…However, it is the UtA PI that better predicts its future development 100,101 and anticipates adverse outcomes related to the condition. 102 Fetuses with estimated fetal weight (EFW) < 10 th centile are considered to be small for gestational age (SGA) and are at increased risk of fetal demise and poor perinatal outcomes when compared with non-SGA fetuses. 20,103,104 Some of these are constitutionally small healthy fetuses, whereas others are failing to reach their potential weight due to an underlying condition -IUGR fetuses.…”

Three-dimensional modeling of the umbilical artery Doppler and its applications in preeclampsia assessment: a case-control study

“…Studies have discussed that it is the uterine artery PI rather than the umbilical artery PI that could screen for PE and predict its adverse outcome [33,34,35].…”

“…Others proposed that PI prediction power should be interpreted with caution. Owing to the high false positive rate, which ranged from 10-70%, especially for late-onset PE [34,36,37].…”