Uterine artery pulsatility index in hypertensive pregnancies: When does the index normalize in the puerperium?

Abstract

ObjectiveTo investigate whether the uterine artery pulsatility index (UtA PI) of hypertensive pregnancies is higher than that of normal pregnancies in the puerperium, as well as in the antepartum period.MethodsThe UtA PI was measured in hypertensive (group 1) and normal pregnancies (group 2) during antepartum, immediate postpartum or late postpartum periods. Using the transvaginal approach, the bilateral uterine artery indices were measured.ResultsOne hundred twenty-two women were enrolled: group 1, hypertensive disease in pregnancy (11 cases in antepartum, 13 cases in immediate postpartum and 10 cases in late postpartum period); group 2, normal pregnancies (32 cases in antepartum, 29 cases in immediate postpartum and 27 cases in late postpartum). In antepartum and immediate postpartum periods, the mean UtA PI and the proportion of cases with an early diastolic notch were higher in group 1 than in group 2 (antepartum mean UtA PI, 1.14 in group 1 vs. 0.68 in group 2, P<0.001; early diastolic notch, 46% vs. 9%, P<0.05; immediate postpartum mean UtA PI, 1.30 vs. 1.08, P<0.05; early diastolic notch, 85% vs. 48%, P<0.05). In late postpartum period, the mean value of UtA PI of group 1 was still higher than that of group 2, although the proportion of cases with an early diastolic notch was not different (mean UtA PI, 1.43 vs. 1.20, P<0.05; early diastolic notch, 60% vs. 52%, P=0.73).ConclusionThe UtA PI in hypertensive pregnancies was still higher than normal pregnancies in puerperal periods, suggesting that more than several weeks are required to resolve increased uterine artery vascular impedance.

Doppler ultrasound evaluation in pre-eclampsia: A case-control study

“…A study in South Korea revealed almost the same result, but with no significant statistical association between the study groups. 25 The difference in the methods and the number of umbilical artery waveforms studied can account for the different values reported in various studies.…”

Usefulness of uterine artery Doppler velocimetry as a predictor for hypertensive disorders in pregnancy in women with prehypertension before 20 weeks gestation

“…[21,22] The presence of an increased uterine artery PI with early diastolic notch suggests increased peripheral vascular resistance and impaired placental perfusion, which may lead to adverse pregnancy outcomes. [18,23] Prediction of PE using Doppler depends on the gestational weeks, and Antsaklis et al demonstrated that 24 of gestational weeks Doppler value have high sensitivity (76.1%), specificity (95.1%) and positive predictive value (34%). [24] Our study found lower Doppler performance for predicting of PE which may be due to the early weeks of gestation 21 at which studies were performed.…”