Umbilical and uterine artery flow velocity waveforms in pregnancy complicated by major fetal abnormality

Background: Although Doppler ultrasound has been applied in obstetrical practice for several years, its role in fetal abnormality is rarely mentioned. Materials and methods: Flow velocimetry waveforms were recorded from the umbilical arteries and branches of the uterine arteries using continuous wave Doppler ultrasound in 160 pregnancies complicated by major fetal abnormalities at National Taiwan University Hospital and Mackay Memorial Hospital. Results: In 32 patients, the umbilical artery waveform systolic/diastolic (S/D) ratios were high. Half (16/32) were growth-retarded fetuses, whereas only 9% (12/128) were growth-retarded in the group of normal umbilical artery waveforms. Sixteen of the 28 growth-retarded fetuses exhibited a high S/D ratio in the umbilical artery waveforms. The uterine artery waveforms were normal in all but eight of the cases with hydrops fetalis, which were also complicated by intrauterine growth retardation. No correlation was found between the type of fetal abnormality and the umbilical or uterine artery waveform. The perinatal mortality for the fetuses delivered at or after 28 weeks of gestation was 91% (20/22) in the group of abnormal umbilical artery waveforms and 61% (60/98) in the group of normal waveforms. Conclusion: Doppler velocimetry can detect fetal well-being and growth, but not the type of fetal abnormality.