Comparison of power Doppler and velocimetry in predicting outcome of high-risk pregnancy

Abstract

Objective: Prospectively evaluate semi-quantitative computer analysis of power Doppler (PD) signals in the placenta, fetal brain, lung, liver, kidney and spleen in high-risk pregnancies in relationship to perinatal outcome and also to compare tissue blood flow in the fetal brain and placenta with Doppler velocimetry. Methods: PD signals were recorded in 180 high-risk pregnancies between 27 and 41 weeks of gestation. Images from PD angiographic scans were transmitted for computer analysis of pixel intensity. Mean flow signal intensity was recorded for each organ. The PD brain/lung ratio was calculated. The PD results were plotted on reference values and related to perinatal outcome. Middle cerebral (MCA), umbilical (UA) and uterine artery (Ut. A) velocimetry was also performed. Results: High-risk pregnancies displayed lower PD signal intensity from the placenta, fetal lung, liver and kidney as compared to normals. However, the brain and spleen signals showed higher intensities suggesting increased tissue perfusion. PD signals from the fetal brain, lung, placenta and PD brain/lung ratio were correlated with perinatal outcome. The PD signal intensity from the fetal liver, kidney and spleen showed poor correlation with perinatal outcome. Fetal brain tissue blood flow showed better correlation with the outcome than MCA velocimetry. Placental tissue blood flow results were similar in predicting outcome to those obtained by means of UA and Ut. A velocimetry. Conclusion: In comparison with conventional Doppler velocimetry, computer analysis of PD signals, give similar results in the prediction of adverse perinatal outcome.