Correcting umbilical artery flow velocity waveforms for fetal heart rate is unnecessary

Abstract

We prospectively examined 55 normal pregnant women between 32 and 41 (x = 37) weeks' gestation. Five measurements of the umbilical artery peak-systolic/end-diastolic frequency ratio were obtained from each patient during one examination. Comparison of the fetal heart rate and the umbilical artery peak-systolic/end-diastolic frequency ratios between pregnancies 37 weeks' gestation revealed no difference. Subsequently a total of 256 measurements were analyzed as one group. Plotting the individual peak-systolic/end-diastolic frequency ratios against the corresponding fetal heart rates revealed a moderate negative linear correlation: y = 4.15 0.012x, r = -0.36 and p < 0.04. When only heart rates between 120 to 160 beats/min were plotted against peak-systolic/end-diastolic frequency ratios, a weaker correlation was found (r = 0.33, P = 0.15). The difference (mean ± SD) between the obtained and the corrected peak-systolic/end-diastolic frequency ratios was 4.4% ± 3.2%. The 95th percentile of the obtained peak-systolic/end-diastolic frequency ratio was 3.35 and the corrected ratio was 3.27. Averaging of the five measurements obtained from each patient for all 55 patients decreased the 95th percentile value to 3.09 whereas the same procedure for the corrected peak-systolic/end-diastolic frequency ratios decreased it to 3.07. We conclude that although there is a statistically significant negative linear correlation between the fetal heart rate and the umbilical artery peak-systolic/end-diastolic frequency ratio, this relationship is not clinically significant. (AM J OBSTET GVNECOL 1989;160:704-7.)