Doppler velocimetry of the uterine artery as a screening test for gestational hypertension

Abstract

Doppler ultrasound was used to study the main uterine artery flow velocity waveforms in an unselected population of 272 primiparous women at 22 weeks' gestation. The incidences of subsequent complications were as follows: gestational hypertension alone, 4.4%; intrauterine fetal growth retardation alone, 4%; and gestational hypertension with intrauterine growth retardation, 3.6%. The flow velocity waveform was considered abnormal when the resistance index in the uterine artery was greater than 0.58. This identified 9.5% of the population as 'at risk' and predicted either of the above outcomes with an overall sensitivity of 74% (kappa index, 0.72). The sensitivity of prediction for gestational hypertension alone was 50% while for proteinuric gestational hypertension it was 88%. The best result was obtained for the prediction of pregnancies affected by both gestational hypertension and intrauterine growth retardation, where the sensitivity was 100%.