UTERINE AND SPIRAL ARTERY FLOW VELOCITY WAVE-FORMS IN PREGNANCY-INDUCED HYPERTENSION AND OR INTRAUTERINE GROWTH-RETARDATION/

The objectives of this study were to characterize spiral artery flow v elocity waveforms in normal pregnancies and pregnancies complicated by pregnancy-induced hypertension and/or intrauterine growth retardation , and to examine the diagnostic potential for predicting adverse perin atal outcomes in complicated pregnancies compared with uterine and umb ilical artery pow velocity waveforms. In this cross-sectional study, 1 60 normal and 43 complicated pregnancies were assessed by color and pu lsed Doppler during 18-41 weeks of gestation. Flow velocity waveforms were obtained from the spiral, uterine and fetal umbilical arteries. I n normal pregnancies, the resistance index of spiral artery flow veloc ity waveforms decreased significantly with advancing gestation (r = -0 .256, p < 0.001). In abnormal pregnancies complicated by pregnancy-ind uced hypertension and/or intrauterine growth retardation, the incidenc e of adverse perinatal outcome was significantly higher in patients wi th abnormal spiral artery resistance indices than in patients with nor mal spiral artery resistance indices (p < 0.001). An abnormal spiral a rtery resistance index had a better diagnostic accuracy for adverse pe rinatal outcome (sensitivity 85.0%, specificity 91.3%, positive predic tive value 89.5%, negative predictive value 87.5%, accuracy 88.4%) whe n compared with the resistance index of uterine and umbilical artery w aveforms and presence of a diastolic notch of the uterine artery wavef orm. Color flow imaging facilitates the precise analysis of spiral art ery flow velocity waveforms and provides more accurate information abo ut the uteroplacental circulation in the evaluation of placental funct ion.