Implicações clínicas das características do fluxo útero-placentário na gravidez complicada por hipertensão.

Abstract

The study of the relationship between maternal and perinatal outcome with uterine blood flows using a continuous wave Doppler unit, in hypertensive patients was the aim of our work. One hundred and thirty seven pregnant hypertensive women seen and delivered at the Department of Obstetrics, Santa Maria Hospital, Lisbon, were included in the study. Blood flows were classified as abnormal if and when the systolic/diastolic ratio was > 2.8 and/or a diastolic notch was seen in one or both uterine arteries. The cases were divided in 2 groups (normal/abnormal) according to the uterine blood flow and correlated with maternal and perinatal outcomes. Twenty-three of 26 maternal complications occurred in cases with abnormal uterine artery blood flow; we also found the large majority of perinatal complications within this group (100% perinatal deaths, 88% of the intrauterine growth retardation, 92% preterm deliveries, 93% fetuses with absent or reverted diastolic umbilical flow, 88% cardiotocographic patterns of fetal distress and 84% of the newborns admitted to the neonatal care unit). In conclusion, in pregnancies complicated by hypertension, uterine artery blood flow evaluation by continuous wave Doppler may identify a set of patients needing closer prenatal surveillance.