Diagnosis and prognostic value Doppler flow velocity waveform in high risk pregnancies

Abstract

Objective: To determine whether Doppler umbilical artery flow velocity waveforms (FVW) would improve the clinical management and reduce the prenatal morbidity or not, in cases of high risk pregnancies.Methods: A total of 160 pregnant women of 28 weeks or more gestational age were included in this study. The age of the cases were from 20‐ to 30‐year‐old and their gravidity ranged from gravida 1 to 5. The cases were classified into two groups. Low risk group, not associated with medical or obstetric complications and includes 70 cases. High risk groups include, the other 90 cases, such as the following: mild pre‐eclampsia (20), severe pre‐eclampsia (15), diabetes mellitus (10), postdated pregnancy (15), previous one or more cesarean section (15), rheumatic heart (4), decreased perception of fetal movement (3), bronchial asthma (2), Rh incompatibility (2) and previous IUFD. All of them were subjected to thorough general and obstetric examination, investigations, ultrasonic examination, biophysical profile scoring and Doppler umbilical artery FVW study. The cases of low risk group were examined every 2 weeks, while high risk ones, were examined every week or twice weekly according to the results of the previous examination.Results: There is a highly significant difference between values of umbilical artery FVW indices in low and high risk group. Doppler has specificity 92.8% in cases of low risk group while has sensitivity 52.8% and specificity 55.6% in cases of high risk group and it is more sensitive than biophysical profile. Doppler of umbilical artery is very beneficial in cases of pre‐eclampsia, where its sensitivity 78.5% and its specificity 52%.Conclusion: There is a strong association between abnormal FVW and adverse fetal outcome. The Doppler will identify a group of fetuses truly at risk, where intensive fetal monitoring or delivery will be required.