Uterine artery velocimetry in patients with gestational hypertension

OBJECTIVE: To evaluate whether abnormal uterine artery velocimetry in patients with pregnancy-induced hypertension is more predictive of the outcome of pregnancy than the presence of proteinuria and the severity of hypertension. METHODS: A retrospective study was conducted on 344 hypertensive pregnant women who underwent uterine artery Doppler investigation. Patients were classified as either preeclamptic or with gestational hypertension at follow-up 2 months after delivery. Pregnancy outcomes of patients with preeclampsia and gestational hypertension were correlated to uterine artery velocimetry. A further analysis was done dividing patients into mild and severe groups. RESULTS: An abnormal uterine Doppler was related to a significantly earlier week of delivery (32.5 versus 35.3 in preeclampsia, 33.6 versus 38.1 in gestational hypertension), a lower mean birth weight (1494 g versus 2320 g in preeclampsia, 1690 g versus 2848 g in gestational hypertension), and a higher number of growth-restricted fetuses (70% versus 23% in preeclampsia, 75% versus 20% in gestational hypertension). In both mild and severe hypertensive groups, abnormal uterine velocimetry was associated with a worse pregnancy outcome (delivery at week 33.1, versus 37.9 in the mild group; 32.7 versus 37.3 in the severe group; birth weight 1574 g versus 2741 g in the mild group; 1539 g versus 2742 g in the severe group). A multivariable analysis of the presence of proteinuria, severity of hypertension, and uterine Doppler revealed that only an abnormal uterine Doppler was significantly related to adverse perinatal outcome (P <.001). CONCLUSION: Abnormal uterine Doppler was the variable that was more frequently associated with adverse pregnancy outcome.