The impact of umbilical and uterine artery Doppler indices on antenatal course, labor and delivery in a low-risk primigravid population

Aims: To evaluate the impact of umbilical and uterine artery Doppler in the second and third trimester on antenatal course, labor and delivery in a low-risk primigravid population. Methods: Prospective recruitment of 1011 low-risk primigravidas with uterine and umbilical artery Doppler assessment at 22-24 weeks and 36 weeks. All mothers and infants were reviewed postnatally with a retrospective analysis of ultrasound and clinical outcome data. Results: Elevated uterine artery indices were associated with increased rates of threatened miscarriage, higher rates of preeclampsia (PET) and a higher incidence of fetal birth weight < 2(nd) and 9(th) centile for gestation. Uterine artery pulsatility index (PI) > 95(th) centile for gestation was associated with statistically higher rates of small-for-gestational age (SGA) infants. Elevated umbilical artery indices were associated with higher rates of induction of labor and a higher incidence of fetal birth weight infants < 2(nd) and 9(th) centile for gestation. Umbilical artery PI > 95(th) centile for gestation was associated with statistically higher rates of SGA infants. Conclusion: Elevated uterine and umbilical artery indices are associated with higher rates of maternal and fetal disease.