DOPPLER VELOCIMETRY OF THE UMBILICAL ARTERY AS A PREDICTOR OF OUTCOMEIN PREGNANCIES CHARACTERIZED BY ELEVATED BETA-SUBUNIT HUMAN CHORIONIC-GONADOTROPIN

Objective: Women with unexplained elevated maternal serum beta-subunit human chorionic gonadotropin (beta-HCG) are at an increased risk for adverse pregnancy outcome, most likely due to placental abnormalities. Such abnormalities may also result in disturbed blood flow through pl acental vessels. The purpose of this study was to assess whether Doppl er velocimetry of the umbilical artery has a predictive value for preg nancy outcome in patients with unexplained elevated maternal serum bet a-HCG. Study Design: The study group included 63 patients, in whom the only finding was elevated maternal serum beta-HCG. Systolic/diastolic (S/D) ratios were calculated using a continuous wave Doppler measurem ent of the umbilical artery, performed beginning at 22 weeks of gestat ion and followed at 6- to 8-week intervals. Serial results for each in dividual were incorporated into a single 'velocimetry score', calculat ed as the rate of abnormal velocimetry measurements. Results: beta-HCG was found to be associated with poor pregnancy outcome: including int rauterine growth restriction (IUGR) (19%), pregnancy-induced hypertens ion (PIH) (14%), and preterm labor (PTL) (19%). Patients were then div ided into 2 groups according to their velocimetry score: group A, VS l ess than or equal to 80 (n = 47), and group B, VS > 80 (n = 16). A low velocimetry score was associated with a higher rate of IUGR, PIH, and a significantly higher rate of PTL. Conclusions: Umbilical artery Dop pler velocimetry may serve as a predictor of pregnancy outcome in the high-risk group characterized by unexplained elevated beta-HCG.