Umbilical artery Doppler velocimetry in pregnancies complicated by oligohydramnios

OBJECTIVE: To determine the role of umbilical artery Doppler velocimetry in the management of oligohydramnios. STUDY DESIGN: In a retrospective chart review covering a two-year period, p regnancies with oligohydramnios evaluated by Doppler velocimetry of the umb ilical artery were identified. Those patients with ruptured membranes and c omplex congenital anomalies were excluded from analysis. In the remainder, various measures of perinatal morbidity, including delivery of a small-for- gestational-age infant, preterm delivery, hyperbilirubinemia, requirement f or blood transfusion, and other cardiovascular or pulmonary complications, were correlated with recorded values of the systolic/diastolic (S/D) ratio. RESULTS: Seventy-six subjects were identified for study. Forty-six had norm al S/D ratios; 17 (37%) were associated with identifiable perinatal morbidi ty. When prematurity due to delivery for the sole indication of oligohydram nios was excluded, morbidity occurred in five patients (11%). Conversely, o f the 30 patients with abnormal Doppler indices, 80% had an adverse outcome . CONCLUSION: Pregnancies with oligohydramnios and normal umbilical artery Do ppler velocimetry were significantly (P <.001) less likely to experience al l abnormal perinatal outcome as compared to those with abnormal Doppler ind ices. An elevated S/D ratio identified an increased risk of an adverse peri natal outcome bz women with oligohydramnios. Avoiding intervention in pregn ancies with oligohydramnios and normal umbilical artery Doppler velocimetry may decrease iatrogenic morbidity due to prematurity by as much as 26%.