Does bilateral abnormal uterine artery doppler velocimetry during second trimester predict the pregnancy complications?

Abstract

ETRY DURING SECOND TRIMESTER PREDICT THE PREGNANCY COMPLICATIONS? YONGWON PARK, JAE-SUNG CHO, JONG-CHEOL LIM, EUN-HEE AHN, HAN-SEUNG KWON, BOK-JA KIM, Yonsei University, Obstetrics and Gynecology, Seoul, South Korea OBJECTIVE: To study if abnormal findings in uterine artery Doppler velocimetry (UADV) in second trimester predict the complications of pregnancy depending on whether the finding is unilateral or bilateral. STUDY DESIGN: 1,090 pregnant women who underwent UADV between 20-24 weeks and 28-32 weeks of pregnancy and delivered at Yonsei Medical Center were enrolled in the study. Those with medical complications, multiple gestation and fetal abnormalities were excluded. UADV was performed bilaterally, and abnormal findings were defined as the detection of an early diastolic notch and/or a systolic/diastolic (S/D) ratio of >2.6. The study group was classified according to UADV results between 20-24 weeks. The group with abnormal findings in bilateral uterine artery was designated as Group A, group with unilateral abnormality as Group B, and normal group as Group C. Followup UADV was performed between 28-32 weeks in each group, and frequency of PIH, FGR and preterm delivery (before 34 weeks of gestation) was determined and compared in each group. RESULTS: According to the results of UADV performed between 20-24 weeks of gestation, there were 69 women(6.3%), 196 women(18.0%) and 825 women(75.7%) in Groups A, B and C, respectively. Follow-up UADV during early third trimester showed 62.3%, 82.7% and 97.1% of each group changed to normal findings. The incidences of FGR and PIH were 26.1%, 10.2%, 8.0% and 14.5, 3.6%, 0.1% respectively, thus being significantly lower in Group C. The incidences of preterm delivery were 8.7%, 5.6%, 2.2% respectively. PIH developed in 46.7% of patients with bilateral abnormal findings in both tests, and in none of the patients with normal findings in both tests. CONCLUSION: Abnormal findings in bilateral UADV during second trimester would warrant close follow up for subsequent development of the pregnancy complications.