DOPPLER VELOCIMETRY OF THE UMBILICAL ARTERY AS A PREDICTOR OF PREGNANCY OUTCOME IN PREGNANCIES CHARACTERIZED BY ELEVATED MATERNAL SERUM ALPHA-FETOPROTEIN AND NORMAL AMNIOTIC-FLUID ALPHA-FETOPROTEIN

Objective: Women with elevated maternal serum alpha-fetoprotein (MSAFP ) and normal amniotic fluid alpha-fetoprotein (AFAFP) are at an increa sed risk of an adverse pregnancy outcome. Such MSAFP elevations are pr obably the consequence of transplacental leakage caused by placental a bnormalities. These may result in disturbed bloodflow through placenta l vessels, The purpose of this study was to assess whether measurement of such disturbances by Doppler velocimetry of the umbilical artery h as a predictive value for pregnancy outcome. Study Design: The study g roup consisted of 85 patients, in whom the only finding was elevated m aternal serum alpha-fetoprotein, Systolic/diastolic (S/D) ratios were calculated using a continuous wave Doppler measurement of the umbilica l artery, performed at 6 to 8-week intervals. Serial results for each individual were incorporated into a single 'Velocimetry Score'. Result s: In group B(14 patients) with an abnormally elevated umbilical SID r atio, a higher incidence of intrauterine growth retardation (42.9%), p reterm deliveries (78.6%), and fetal loss (42.9%) was noted, as compar ed with group A (71 patients) with a normal SID ratio. Conclusions: Um bilical artery Doppler velocimetry may serve as a predictor of pregnan cy outcome in the high-risk group characterized by elevated MSAFP.