SCORING OF UTERINE ARTERY FLOW VELOCITY WAVE-FORMS IN THE ASSESSMENT OF FETAL GROWTH RESTRICTION AND OR PREGNANCY-INDUCED HYPERTENSION/

Objective: To evaluate a new scoring method for uterine artery flow ve locity waveforms in the assessment of fetal growth restriction and/or pregnancy-induced hypertension. Patients and methods: Eighty-nine sing leton pregnancies complicated with fetal growth restriction and/or pre gnancy-induced hypertension were assessed with the new scoring method for uterine artery flow velocity waveforms (the uterine artery score). In the new scoring method, bilateral uterine artery flow velocity wav eforms were evaluated by measuring resistance index and assessing the presence of diastolic notch. Abnormal resistance index or the presence of diastolic notch was given a score of 1 point, and normal resistanc e index or the absence of diastolic notch was given a score of zero. T he final uterine artery score was calculated for the right plus left ( score range, 0-4). Results: In the 89 patients, the distribution of sc ores was;Is follows: 0 in 20, 1 in 8, 2 in 17, 3 in 18, and 4 in 26. A s the score increased, the incidence of fetal distress and of pregnanc y-induced hypertension was increased, and the birth weight and gestati onal age at delivery were decreased. Significant differences were foun d in these variables. In all five pregnancies in which abruptio placen tae developed, the score was 4. A score above 3 had the highest diagno stic accuracy for adverse perinatal outcomes (sensitivity, 74.5%; spec ificity, 84.2%; positive predictive value, 86.3%; negative predictive value, 71.1%; and accuracy, 78.7%). Conclusion: The uterine artery sco re including measures of both resistance index and diastolic notch is a simple and useful tool in identifying high risk pregnancies that req uire intensive fetal and maternal surveillance.