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Maternal and fetal blood flow velocity waveforms in patients with preterm labor: relationship to outcome
H S Brar1, A L Medearis, G R De Vore
1Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
Elevated systolic/diastolic ratios obtained by umbilical and uterine velocimetry have been used to predict adverse pregnancy outcome. We performed pretherapy umbilical and uterine velocimetry by means of continuous-wave Doppler ultrasonography on 92 patients who came for treatment in preterm labor. Fourteen (15.2%) and 12 (13%) patients had elevated uterine (greater than 2.6) and umbilical (greater than 3.5) systolic/diastolic ratios, respectively, and 9 (9.8%) patients had both ratios elevated. Overall 17 (18.5%) patients had at least one abnormal systolic/diastolic ratio. Patients with abnormal Doppler waveforms had a significantly shorter gestation, infants with lower birth weights, and a higher incidence of adverse pregnancy outcome as determined by meconium, cesarean section for fetal distress, low 1- and 5-minute Apgar scores, and days in the neonatal intensive care unit, compared with patients with normal systolic/diastolic ratios. There was no significant difference in the ability of uterine, umbilical, or combined velocimetry to predict preterm birth or adverse pregnancy outcome. Doppler studies in preterm labor patients may help to identify patients at increased risk for preterm birth and poor pregnancy outcome. Further studies are warranted to assess its usefulness in the evaluation of these patients.
Elevated systolic/diastolic ratios obtained by umbilical and uterine velocimetry have been used to predict adverse pregnancy outcome. We performed pretherapy umbilical and uterine velocimetry by means of continuous-wave Doppler ultrasonography on 92 patients who came for treatment in preterm labor. Fourteen (15.2%) and 12 (13%) patients had elevated uterine (greater than 2.6) and umbilical (greater than 3.5) systolic/diastolic ratios, respectively, and 9 (9.8%) patients had both ratios elevated. Overall 17 (18.5%) patients had at least one abnormal systolic/diastolic ratio. Patients with abnormal Doppler waveforms had a significantly shorter gestation, infants with lower birth weights, and a higher incidence of adverse pregnancy outcome as determined by meconium, cesarean section for fetal distress, low 1- and 5-minute Apgar scores, and days in the neonatal intensive care unit, compared with patients with normal systolic/diastolic ratios. There was no significant difference in the ability of uterine, umbilical, or combined velocimetry to predict preterm birth or adverse pregnancy outcome. Doppler studies in preterm labor patients may help to identify patients at increased risk for preterm birth and poor pregnancy outcome. Further studies are warranted to assess its usefulness in the evaluation of these patients.