Clinical significance of normalization of uterine artery pulsatility index with maternal heart rate for the evaluation of uterine circulation in pregnancy-induced hypertension.

Abstract

OBJECTIVE:

To investigate whether the use of normalized pulsatility index (PI) improves evaluation of the fetal prognosis in pregnancy-induced hypertension (PIH).

METHOD:

Eighty women with uncomplicated pregnancies and 46 women with PIH (33 with pre-eclampsia and 13 with gestational hypertension) were included in the study. Uterine artery PI and normalized PI were analyzed in relation to two neonatal parameters: incidence of small-for-gestational age infants and incidence of Cesarean section for non-reassuring fetal status.

RESULTS:

In normal pregnancy, the normalized uterine artery PIs (mean +/- SD) at 25, 31, and 39 weeks of gestation were 0.70 +/- 0.15, 0.71 +/- 0.16, and 0.65 +/- 0.13, respectively. Using non-normalized PI, 10 of 46 PIH cases had increased PI; however, with normalization, two pre-eclampsia cases were added to the group with elevated PI, giving a total of 12. The incidences of small-for-gestational age infants and Cesarean section due to non-reassuring fetal status were higher in the elevated normalized uterine artery PI group. The use of normalized PI appeared to reduce the false-negative results in pre-eclampsia and PIH. After normalization, sensitivity, positive predictive value and negative predictive value of PI for small-for-gestational age infants and Cesarean section due to non-reassuring fetal status were improved in cases with pre-eclampsia and PIH. The incidence of these complications was low in gestational hypertension.

CONCLUSIONS:

Normalization of the PI may improve predictive values for small-for-gestational age infants and delivery by cesarean section due to non-reassuring fetal status in PIH.

• Authors: H Ochi, Y Kusanagi, T Katayama, K Matsubara, M Ito
• Journal: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology (Ultrasound Obstet Gynecol) Vol. 21 Issue 5 Pg. 459-63 (May 2003) ISSN: 0960-7692 [Print] England
• PMID: 12768557 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article)
• Copyright: Copyright 2003 ISUOG. Published by John Wiley & Sons, Ltd.

Topics

• Adult
• Arteries (physiology)
• Female
• Gestational Age
• Heart Rate (physiology)
• Humans
• Hypertension (physiopathology)
• Placental Circulation (physiology)
• Pre-Eclampsia (physiopathology)
• Pregnancy
• Pregnancy Complications, Cardiovascular (physiopathology)
• Pulsatile Flow (physiology)
• Sensitivity and Specificity
• Uterus (blood supply)