Evaluation of placental Doppler velocimetry in pregnancies complicated with oligohydramnios

Abstract

Objective: The objective of the study was to evaluate intraplacental Doppler indices in pregnancies complicated with oligohydramnios.Methods: Thirty‐six singleton pregnancies between 32 and 39 weeks complicated with oligohydramnios (cases of premature rupture of the membranes and fetal malformations were excluded from the study) and 40 normal pregnancies were examined by real time ultrasonography, color and pulse Doppler. Placental Doppler velocity waveforms were estimated in the placental cord insertion (umbilical artery velocimetry) and in three different pulsatile intraplacental vessels (the mean value). Placental Doppler velocity waveforms analysis was performed on the base of Haberman and Friedman method. The ratios between intraplacental and umbilical artery pulsatility index values were calculated. Fetal well‐being was evaluated by means of non‐stress test analyzed according to Fischer method.Results: In normal pregnancies group all Doppler velocity waveforms values were between 10 and 90th percentile of the normal for gestational age values based on Doppler indices nomograms, as well as all patients had the normal (<1) intraplacental to umbilical artery pulsatility index ratio. In the group complicated with oligohydramnios in 15 patients abnormal (>1) intraplacental to umbilical pulsatility index ratio were observed (P < 0.05, sensitivity 42%, specificity 100%, positive predictive value 100%, negative predictive value 65%). In that group the results of non‐stress test analysis according to Fisher method were pathological (Fisher <5) significantly more often (P < 0.05).Conclusion: The results of the study demonstrate, that in pregnancies complicated with oligohydramnios the evaluation of intraplacental to umbilical pulsatility index ratio is a valuable method for estimation the fetoplacental circulation and is an important complement of fetal well‐being assessment.