UTERINE ARTERY WAVE-FORM AS A PREDICTOR OF PREGNANCY OUTCOME IN WOMENWITH UNDERLYING RENAL-DISEASE

To investigate the use of uterine artery flow velocity waveforms in pr edicting gestational hypertension (GH), preeclampsia (PE) and intraute rine growth retardation (IUGR), Colour Doppler ultrasound of the uteri ne arteries was performed at 19-24 weeks gestation in 51 women with kn own renal disease. On four consecutive waveforms, peak systolic (A), e nd-diastolic (B) and early diastolic (C) velocities were measured. Res istance index (RI) was calculated as (A-B)/A, and the severity of the waveform notch expressed as the AC ratio (A/C). Gestational hypertensi on was defined as a blood pressure (BP) greater than or equal to 140/9 0 mmHg with an increase of at least 15 mmHg in diastolic BP. PE includ ed women with gestational hypertension and proteinuria >300 mg/24 h or a doubling of early gestation protein excretion. IUGR was defined as a birthweight less than the 10th percentile for gestation. RI and/or A C ratio in 14 women (27%) exceeded the 90th percentile for gestational age of our low risk control population. Of the women with an abnormal test, 11 (79%) developed complications, 8 (57%) developed GH or PE, 3 (21%) IUGR alone, 2 (14%) GH and IUGR, and in one woman intrauterine fetal death of an IUGR infant occurred, and 3 (21%) had an uncomplicat ed pregnancy. Of the women with a normal test, 34 (92%) had an uncompl icated pregnancy, and only 3 (8%) developed GH or IUGR. In summary, ut erine artery waveform indices at 19-24 weeks gestation may be useful f or the prediction of pregnancy complications in woman with underlying renal disease.