Uterine and umbilical artery Doppler are comparable in predicting perinatal outcome of growth-restricted fetuses


Dr GS Ghosh, Department of Obstetrics and Gynecology, Malmö University Hospital, University of Lund, SE-20502 Malmö, Sweden. Email gisela.ghosh@med.lu.se


Objective  To compare umbilical and uterine artery Doppler in predicting outcome of pregnancies suspected of fetal growth restriction (FGR).

Design  A prospective study included 353 singleton pregnancies complicated by an FGR fetus.

Setting  University Hospital setting.

Sample  Pregnancies suspected of FGR diagnosed by ultrasound fetal biometry during a 5-year period.

Main outcome measure  Perinatal outcome in relation to uterine and umbilical artery Doppler.

Methods  The women underwent Doppler examination of the umbilical and uterine arteries. Results from the uterine, but not the umbilical artery, were blind to the woman and managing obstetrician. The Doppler results were related to perinatal outcomes including small for gestational age newborns, caesarean delivery, premature delivery (<37 weeks of gestation) and admission of the newborn to a neonatal intensive care unit.

Results  Abnormal uterine artery Doppler velocimetry was seen in 120 (33.4%) pregnancies and abnormal umbilical artery Doppler in 102 (28.4%). There was a statistically significant correlation between abnormal Doppler of both the umbilical and uterine arteries and adverse outcome of pregnancy. The two vessels were comparable in predicting adverse outcome. Women with normal umbilical artery Doppler (251) were analysed separately. Abnormal uterine artery Doppler, seen in 61 (24.3%) of those women, showed a statistically significant correlation for adverse outcome of pregnancy.

Conclusions  Doppler examinations of the uterine and/or the umbilical arteries seem to be comparable as predictors of outcome in pregnancies complicated by FGR. Including uterine artery Doppler in the surveillance of growth-restricted fetuses might detect a group of pregnancies at high risk, even though the umbilical artery Doppler was normal.