JCOGP
Journal of Controversies in Obstetrics & Gynecology and Pediatrics

As of January 2023, our "Journal of Controversies Obstetrics & Gynecology and Pediatrics" has been published under the Medihealth Academy to publish all articles, reviews and case reports on Pediatrics, especially in the field of Obstetrics and Gynecology. In order to facilitate the citation of the articles, to take our place in internationally respected indexes and to reach a wider readership, we will pay attention to the fact that our article language is only English in terms of acceptance. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

ISSN: Active
eISSN: 2980-0579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
The role of umbilical artery Doppler analysis in estimating perinatal morbidity and mortality in hypertensive pregnancy
Abstract
Aims: Uteroplacental (uterine artery systolic/diastolic (S/D) ratio) and fetal circulation changes (umbilical artery pulsatility Index (PI) value) can be evaluated non-invasively by using Doppler ultrasonography spectral analysis. The present study aimed to demonstrate how Doppler ultrasonography should be combined with classical well-being tests to detect perinatal morbidity and mortality in hypertensive pregnancy.
Methods: This prospective research was carried out with 88 pregnant women diagnosed with high-risk pregnancy and hypertension between April 1992 and May 1994. A non-stress test (NST) was performed in all cases, and fetal distress was evaluated by a biophysical profile (BP) and/or a contraction stress test (CST) subsequent to a non-reactive NST. Following the diagnosis of hypertension, longitudinal maternal (uterine artery) and fetal (umbilical artery) Doppler analyses were initiated at 7–10-day intervals. In the study, the Acuson 128 XP 10 device (Research project No. 515/080555592 was funded by the İstanbul University Research Fund) and a 3.5-5 MHz curvilinear probe were used. No Doppler pathology was considered solely in the timing of delivery.
Results: There was no case of perinatal loss, antepartum and intrapartum fetal distress, neonatal asphyxia, and oligohydramnios in the group with normal uterine and umbilical artery Doppler analyses. There was one case with umbilical artery Doppler flow pathology only, which was delivered by preterm cesarean section with the diagnosis of antepartum fetal distress. Fetus diagnosed to have a fetal growth restriction (FGR) and the findings of fetal distress, FGR, and cesarean delivery were concordant with the literature. There was also increased perinatal mortality (9.1%) among patients with pathological uterine artery Doppler and normal umbilical artery Doppler group, but there was no case of oligohydramnios in this group and the rate of neonatal asphyxia (5.min Apgar score <7) was 21.7%. The antepartum loss was 27%, the neonatal loss was 23.8%, and perinatal mortality was 44.8% in the group with pathological uterine and umbilical artery Doppler findings, and this group had all cases of oligohydramnios.
Conclusion: Overall, it seems reasonable to identify any pathologies with Doppler ultrasonography in hypertensive pregnant women in the early pregnancy and to follow them up with classical fetal antepartum surveillance tests at appropriate intervals related to their umbilical artery Doppler pathologies.

Keywords : Doppler ultrasonography, pregnancy, hypertension

Download Article


1. Rochat RW, Koonin LM, Atrash HK, Jewett JF. Maternal mortality inthe United States: report from the Maternal Mortality Collaborative.Obstet Gynecol. 1988;72(1):91-97.
2. FitzGerald DE, Drumm JE. Non-invasive measurement ofhumanFitzGerald, D E, and J E Drumm. &ldquo;Non-invasive measurementof human fetal circulation using ultrasound: a new method.&rdquo; Br Med J1977;6100 (1977):1450-1. doi:10.1136/bmj.2.6100.1450.
3. Stuart B, Drumm J, FitzGerald DE, Duignan NM. Fetal blood velocitywaveforms in normal pregnancy. Br J Obstet Gynaecol. 1980;87(9):780-785. doi:10.1111/j.1471-0528.1980.tb04613.x.
4. Gosling RG, Dunbar G, King DH, et al. The quantitative analysis ofocclusive peripheral arterial disease by a non-intrusive ultrasonictechnique. Angiology. 1971;22(1):52-55. doi:10.1177/000331977102200109.
5. Pourcelot L: applications cliniques de I&rsquo; examen Doppler transcutane.inPeronneau P(ed): Velicimetrie Ultrasonore Doppler 34. Paris,INSERM, 1974,p 213.
6. Farmakides G, Schulman H, Schneider E. Surveillance of the pregnanthypertensive patient with Doppler flow velocimetry. Clin ObstetGynecol. 1992;35(2):387-394.
7. Oloyede OA, Iketubosin F. Uterine artery Doppler study in secondtrimester of pregnancy. Pan Afr Med J. 2013;15:87. doi:10.11604/pamj.2013.15.87.2321.
8. Varghese S, Kour G, Manchanda K, Dhar T. Abnormal umbilical arteryDopplerin third trimester and perinatal outcome: a retrospectivestudy.Int J Reprod Contracept Obstet Gynecol. 2016;5:2196-9.
9. Ducey J, Schulman H, Farmakides G, et al. A classification ofhypertension in pregnancy based on Doppler velocimetry. Am J ObstetGynecol. 1987;157(3):680-685. doi:10.1016/s0002-9378(87)80028-5.
10. Trudinger BJ, Cook CM. Doppler umbilical and uterine flowwaveforms in severe pregnancy hypertension. Br J Obstet Gynaecol.1990;97(2):142-148. doi:10.1111/j.1471-0528.1990.tb01739.x.
11. Rochelson B, Schulman H, Farmakides G, et al. The significance ofabsent end-diastolic velocity in umbilical artery velocity waveforms.Am J Obstet Gynecol. 1987;156(5):1213-1218. doi:10.1016/0002-9378(87)90147-5.
12. Brar HS, Platt LD. Reverse end-diastolic flow velocity on umbilicalartery velocimetry in high-risk pregnancies: an ominous finding withadverse pregnancy outcome. Am J Obstet Gynecol. 1988;159(3):559-561.doi:10.1016/s0002-9378(88)80007-3.
13. Campbell S, Diaz-Recasens J, Griffin DR, et al. New doppler techniquefor assessing uteroplacental blood flow. Lancet. 1983;1(8326 Pt 1):675-677. doi:10.1016/s0140-6736(83)91970-0.
14. Fleischer A, Schulman H, Farmakides G, et al. Uterine artery Dopplervelocimetry in pregnant women with hypertension. Am J ObstetGynecol. 1986;154(4):806-813. doi:10.1016/0002-9378(86)90462-x.
15. Berkowitz GS, Mehalek KE, Chitkara U, Rosenberg J, Cogswell C,Berkowitz RL. Doppler umbilical velocimetry in the predictionof adverse outcome in pregnancies at risk for intrauterine growthretardation. Obstet Gynecol. 1988;71(5):742-746.
16. Reuwer PJ, Sijmons EA, Rietman GW, van Tiel MW, Bruinse HW.Intrauterine growth retardation: prediction of perinatal distress byDoppler ultrasound. Lancet. 1987;2(8556):415-418. doi:10.1016.
17. Rochelson BL, Schulman H, Fleischer A, et al. The clinical significanceof Doppler umbilical artery velocimetry in the small for gestational agefetus. Am J Obstet Gynecol. 1987;156(5):1223-1226. doi:10.1016/0002-9378(87)90150-5.
18. McCowan LM, Erskine LA, Ritchie K. Umbilical artery Doppler bloodflow studies in the preterm, small for gestational age fetus. Am J ObstetGynecol. 1987;156(3):655-659. doi:10.1016/0002-9378(87)90071-8.
19. Arduini D, Rizzo G. Fetal renal artery velocity waveforms andamniotic fluid volume in growth-retarded and post-term fetuses.Obstet Gynecol. 1991;77(3):370-373.
20. Reed KL, Anderson CF, Shenker L. Changes in intracardiac Dopplerblood flow velocities in fetuses with absent umbilical artery diastolicflow. Am J Obstet Gynecol. 1987;157(3):774-779. doi:10.1016/s0002-9378(87)80048-0.
21. Boyd PA, Lindenbaum RH, Redman C. Pre-eclampsia and trisomy13: a possible association. Lancet. 1987;2(8556):425-427. doi:10.1016/s0140-6736(87)90960-3.
22. Schulman H, Fleischer A, Farmakides G, Bracero L, RochelsonB, Grunfeld L. Development of uterine artery compliance inpregnancy as detected by Doppler ultrasound. Am J Obstet Gynecol.1986;155(5):1031-1036. doi:10.1016/0002-9378(86)90340-6.
23. Arabin B, Siebert M, Jimenez E, Saling E. Obstetrical characteristicsof a loss of end-diastolic velocities in the fetal aorta and/or umbilicalartery using Doppler ultrasound. Gynecol Obstet Invest. 1988;25(3):173-180. doi:10.1159/000293767.
24. Divon MY, Girz BA, Lieblich R, Langer O. Clinical management of thefetus with markedly diminished umbilical artery end-diastolic flow.Am J Obstet Gynecol. 1989;161(6 Pt 1):1523-1527. doi:10.1016/0002-9378(89)90917-4.
Article available in :
Volume 1, Issue 2, 2023
Page : 36-40
https://doi.org/10.51271/JCOGP-0009
Article Information
Received : 04 Nis 2023
Accepted : 09 Nis 2023
Published : 28 Nis 2023
Corresponding Author :

Tanju Demirören: Yeditepe University Medical Faculty

[email protected]
Citation : Demirören T, Yüksel A. The role of umbilical artery Doppler analysis in estimating perinatal morbidity and mortality in hypertensive pregnancy. J Controv Obstetr Gynecol Ped. 2023;1(2):36-40.

Read: 330
Cited: 0
Download : 243
_Footer