Quantification of the diastolic notch in Doppler ultrasound screening of uterine arteries

Objective To investigate a new method of quantification of the diastolic no tch of the flow velocity waveforms of uterine arteries in the prediction of hypertensive disorders of pregnancy. Methods Pulsed-wave Doppler was used to obtain flow velocity waveforms (FVW s) from the uterine arteries at 21-22 weeks of gestation from 531 nulliparo us women and 94 multiparous women at high risk. From the FVWs, both the pul satility index (PI) and the notch index (NI) were calculated and the predic tive values for both indices were compared using logistic regression analys is for mild and severe early onset hypertensive pregnancy complications. Results Both the PI and the NI were poor predictors for mild gestational hy pertension and pre-eclampsia; predictive values for severe early onset dise ase, however, were much better Logistic regression analysis showed the NI h as no additional value compared with the Pf in the prediction of either mil d or severe disease. Conclusions The NI offers the possibility to quantify the diastolic notch i n uterine artery analysis. Compared to the PI, this does not lead to better predictive values for hypertensive disorders of pregnancy.