The utility of umbilical artery Doppler investigation in women with the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome.

Abstract

OBJECTIVE:

Our aim was to study the utility of umbilical artery Doppler velocimetry in the management of women with the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome.

STUDY DESIGN:

Fetuses of women with the HELLP syndrome underwent ultrasonographic evaluation at initial presentation. An abnormal umbilical artery Doppler study was defined as a systolic/diastolic ratio >5.0. The systolic/diastolic ratios were correlated with outcome variables including laboratory findings, latency, mode of delivery, and birth weight.

RESULTS:

Fifty women were enrolled into the study. Eighteen of the fetuses (36%) had abnormal waveforms, with 8 fetuses demonstrating either absent or reversed end-diastolic umbilical artery blood flow. The mean umbilical artery systolic/diastolic ratio was significantly higher for fetuses with intrauterine growth restriction or who were small for gestational age than for those without these diagnoses (P =.001, for each). No correlation was observed between the systolic/diastolic ratio and the laboratory findings at admission, the degree of hypertension at admission, or the latency to delivery (all, P >.05). No woman with a fetus at a viable gestational age having abnormal Doppler waveforms had a successful vaginal delivery.

CONCLUSION:

Abnormal umbilical artery Doppler velocimetry is associated with a higher risk of fetal growth restriction and a high likelihood of cesarean delivery. These values were not correlated with the severity of maternal disease.

• Authors: K D Bush, J M O'brien, J R Barton
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 184 Issue 6 Pg. 1087-9 (May 2001) ISSN: 0002-9378 [Print] United States
• PMID: 11349165 (Publication Type: Journal Article)

Topics

• Blood Flow Velocity
• Cesarean Section
• Female
• Fetal Growth Retardation (diagnostic imaging)
• HELLP Syndrome (diagnostic imaging, physiopathology)
• Humans
• Middle Aged
• Pregnancy
• Ultrasonography, Prenatal
• Umbilical Arteries (diagnostic imaging, physiopathology)