DOPPLER VELOCIMETRY OF THE UTERINE ARTERIES IN NULLIPAROUS WOMEN

The aim of this study was to evaluate the role of uterine artery Doppl er velocimetry performed at 20 and 24 weeks gestation in predicting ge stational hypertension and small-for-gestational age babies in a popul ation of nulliparous women. Four hundred and fifty-six patients withou t risk factors for pregnancy complications and with fetuses free from structural abnormalities at ultrasonographic examination at 20 weeks g estation were considered in the study. During the routine 20 weeks ult rasound a continuous-wave Doppler examination of the uterine arteries was performed. The patients with abnormal uterine Resistance Index (RI ) repeated the Doppler evaluation at 24 weeks by means of Colour Doppl er equipment. Among the 419 women who completed the study an abnormal Doppler uterine arteries velocimetry was found in 8.6% of the patients . Pregnancy complications (gestational hypertension and/or small-for-g estational age babies) were observed in 56% of the patients presenting high uteroplacental RI versus 10% of those with normal uterine artery velocimetry (P = 0.0001). In the group of patients with an abnormal R I value, the presence of a diastolic notch in one or both of the uteri ne arteries identified a population of pregnant women at higher risk f or pregnancy complications when compared with patients without notch ( 78% vs. 33%, P = 0.007). The knowledge of the uteroplacental resistanc e can help in identifying a subgroup of patients at higher risk of hyp ertensive disorders and small-for-gestational age babies that could be nefit from prophylaxis with low dose aspirin. (C) 1997 Elsevier Scienc e Ireland Ltd.