CLINICAL FINDINGS IN GESTATIONAL HYPERTENSION CATEGORIZED BY DOPPLER VELOCIMETRY

Objective: Doppler velocimetry can supply important information about uterine and fetal circulation in pregnancies complicated by hypertensi on and intrauterine growth retardation. We have studied the clinical i mplications and the maternal and neonatal outcomes in women affected b y gestational hypertension with different vascular patterns. Methods: Thirty-eight patients affected by gestational hypertension were select ed and subdivided into four groups according to Doppler velocimetry in maternal (uterine arteries) and in fetal (middle cerebral artery! umb ilical artery ratio) circulation. Group I included patients with norma l fetal and maternal velocimetry; group II included women with normal uterine artery velocimetry and abnormal fetal velocimetry; group III i ncluded mothers with abnormal uterine velocimetry only; and group IV i ncluded patients in whom both fetal and uterine velocimetries were abn ormal. The incidence of adverse perinatal events in the four study gro ups was evaluated as well as the relationship between birth weight and Doppler velocimetry acid between gestational age and Doppler velocime try. Results: Forty percent of women had normal velocimetric patterns, and the maternal and perinatal morbidity were not very different from that observed in a normal population, The worst perinatal events were observed in the presence of isolated abnormal fetal velocimetry (grou p II) or when maternal and fetal velocimetry were both abnormal (group IV), A significant relationship exists between maternal (r = -0.55; P = 0.0003) and fetal (r = -0.65; P = 0.0001) velocimetry and neonatal birth weight, as well as between maternal (r = -0.43; P = 0.005) and f etal (r = 0.56; P = 0.0002) velocimetry and gestational age. Conclusio ns: We suggest that Doppler velocimetry is a useful method to detect p regnant women at higher risk of developing poor perinatal outcome due to gestational hypertension.