152. Placental pathology and neonatal outcome in relation to uterine artery Doppler velocimetry in pregnancies complicated by placenta syndrome

Abstract

Objectives High resistance utero-placental circulation leads to placenta insufficiency related complications for both mother and fetus. The objective of this study was to evaluate the relationship between abnormal uterine artery pulsatility index (UtAPI) Doppler measurements, neonatal outcome and placental histological findings in placenta syndrome (PS) pregnancies. Methods A retrospective pilot study was performed on singleton pregnancies complicated by PS (pre-eclampsia and/or foetal growth restriction). UtA, umbilical (UmbA) and middle cerebral artery (MCA) Doppler measurements were collected within the last two weeks prior to delivery. Patients were divided into two groups according to UtAPI values, in which UtAPI > p95 was considered abnormal. Histological lesions were classified according to the criteria of the Society for Pediatric Pathology. Statistical analysis was performed using independent T-, Mann-Whitney U- and Fisher’s exact test. Multivariate analysis was used to correct UtAPI for gestational age (GA) at delivery and parity. Results The UtA-PI > p95 group (n = 25) showed a higher rate of premature delivery (p = 0,025), caesarean section (p = 0,007) and NICU-admission (p = 0,001) compared to the UtA-PIp95 group showed a significantly higher UmbA-PI (p = 0,004) with absent or reversed flow (p = 0,002), a lower MCA-PI (p = 0,010) and cerebro-placental ratio (p Conclusions In pregnancies complicated by PS, UtA-PI > p95 showed a moderate predictive ability for placental underperfusion independently of GA at delivery and parity. Furthermore, neonatal outcome and Doppler measurements were poorer.