European Journal of Obstetrics & Gynecology and Reproductive Biology 79 (1998) 47–50 Role of uterine artery Doppler investigation in pregnant women with chronic hypertension * Tiziana Frusca , Mirella Soregaroli, Silvia Zanelli, Luana Danti, Fabiola Guandalini, Adriana Valcamonico Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy Received 6 March 1997; received in revised form 30 November 1997; accepted 13 February 1998 Abstract Objective: To evaluate the role of uterine artery Doppler investigation in predicting perinatal outcome of patients with chronic hypertension. Study design: Uterine artery velocimetry was investigated at 24 weeks gestation in 78 chronic hypertensive pregnant women by means of color Doppler. The resistance index (RI) and the presence of a diastolic notch were recorded and related to the development of superimposed preeclampsia (SPE), pregnancy aggravated hypertension (PAH), and intrauterine growth retardation (IUGR). Results: There were more pregnancy complications in the 25 patients with abnormal RI, compared with the 53 women with normal RI (SPE 12% vs. 0%, PAH 36% vs. 7% and IUGR 52% vs. 2%; P,0.01), and more in women with a bilateral diastolic notch compared with those without (SPE 23% vs. 0%, PAH 54% vs. 4%, IUGR 85% vs. 2%; P,0.0001), while no differences were detected in those with only a unilateral notch, except for PAH (27% vs. 4%; P,0.01). Conclusion: Uterine artery Doppler velocimetry identifies a subgroup of chronic hypertensive patients with a high frequency of pregnancy complications.  1998 Elsevier Science Ireland Ltd. Keywords: Uterine artery Doppler investigation; Chronic hypertension; Pregnancy complications 1. Introduction hypertensive pregnant women, complications were sig- nificantly more common in the group with abnormal Doppler examination of the uterine artery flow velocity uterine Resistance Index (RI), but the presence of a waveform has been used by several authors as a screening diastolic notch was not reported. test for preeclampsia and intrauterine growth retardation. A The aim of this study was to measure the significance of wide range of diagnostic accuracy has been reported, uterine artery Resistance Index and diastolic notch at 24 largely due to variation in the prevalence of disease and weeks in predicting maternal and fetal complications in a use of different endpoints. The positive predictive values larger series of pregnant women with chronic hyperten- are too low [1–7] in low risk patients, but this technique is sion. widely used in women at high risk of adverse pregnancy outcomes [8–10]. Women with chronic hypertension are such a high risk 2. Methods group. To our knowledge, there is only one other study of We examined a group of 78 pregnant women affected by uterine artery velocimetry in predicting adverse perinatal chronic hypertension who delivered between 1st January outcome in chronic hypertensive patients [11]. Among 42 1993 and 31st December 1995. Multiple pregnancies and those with a fetus affected by structural or chromosomal * Corresponding author. Tel.: 139 30 3995340; fax: 139 30 3384460. abnormality were excluded. 0301-2115 / 98 / $19.00  1998 Elsevier Science Ireland Ltd. All rights reserved. PII S0301-2115(98)00045-1