CONTINUOUS-WAVE DOPPLER INVESTIGATION OF UTEROPLACENTAL VESSELS IN HIGH-RISK PREGNANCIES AS PREDICTOR OF FETAL GROWTH-RETARDATION AND PREGNANCY-INDUCED HYPERTENSION

Continuous-wave Doppler sonography of uteroplacental vessels and the u mbilical artery was used as an additive method in the management of ri sk pregnancies. Its major advantage lies in permitting noninvasive acc ess to placental perfusion. In a sample of 650 singleton pregnancies c onsidered at risk, flow patterns of the right and left uterine and arc uate arteries and of the umbilical artery were obtained. Increased res istance in uteroplacental circulation alone (90th percentile of resist ance index and/or notching) was seen in 62 of 100 patients with confir med growth retardation, proving the key role played by uteroplacental perfusion disorders. Early diastolic notching as well as incomplete va scular flow patterns were also found significantly more often in the g rowth-retarded group compared to the controls, especially in pregnanci es additionally beset by hypertensive disorders. Doppler study of both utero- and fetoplacental circulation increased the sensitivity to 76% in pregnancies with intrauterine growth retardation, and to 90% in th ose cases with an additional risk of pregnancy-induced hypertension, w hile the false-positive rate (100-specificity) remained acceptable (17 %).