Doppler sonographic findings for hypertension in pregnancy and HELLP syndrome

Doppler examinations of the umbilical artery, both uterine arteries, and th e fetal middle cerebral artery were performed in the third trimester in Is patients with pregnancy induced hypertension, 52 patients with preeclampsia , and 32 patients with HELLP syndrome and the results were correlated with the parameters fetal outcome. For 74% of the patients this was the first pr egnancy, in 93% of the cases a cesarean section was necessary; 66% of the n ewborn babies were dystrophic and 90% of them were born prematurely. The bl ood flow in one uterine artery was restricted in 95% of all 102 pregnant wo men, only 5% did not show any pathological findings. A pathological blood f low was observed on Doppler sonography in the umbilical artery in 70% of th e group and 39% showed a pathologically increased perfusion of the fetal mi ddle cerebral artery. The average birth weights and gestational ages in the study group were markedly reduced in comparison with healthy pregnant wome n (pregnancy induced hypertension: 1620 g/35 weeks; preeclampsia: 1660 g/34 weeks; HELLP syndrome: 1160 g/31 weeks, respectively). The lowest values f or average birth weight and gestational age occurred when all four investig ated blood vessels showed pathological Doppler findings: 1180 g/31 weeks (0 to 1 pathological vascular findings: 2780 g/38 weeks; 2 pathological vascu lar findings: 1845 g/34.5 weeks; 3 pathological vascular findings: 1330 g/3 1 weeks). This Doppler study underlines the importance of examining four bl ood vessels: the uterine, the umbilical, and the fetal middle cerebral arte ries for a complete analysis of the fetoplacental hemodynamics. On account of the severely impaired hemodynamics observed in the placentas of our pati ents with hypertensive diseases in pregnancy or HELLP syndrome, we believe the early diagnosis of these disorders by Doppler sonography and an early s tart of therapy to be essential.