Journal of Ultrasound in Medicine, Vol 10, Issue 6 323-326, Copyright © 1991 by American Institute of Ultrasound in Medicine
Can umbilical artery pulsatility index predict the outcome of fetuses with structural heart disease?
J. A. Copel, J. C. Hobbins and C. S. Kleinman
Yale Fetal Cardiovascular Center, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06510-8063.
Umbilical artery Doppler waveforms have been suggested to demonstrate
diminished end-diastolic velocities in anomalous fetuses. We evaluated 11
fetuses with antenatally diagnosed congenital heart disease (CHD) and
compared them to a normal population. Fetuses with CHD were studied once
each and ranged in age from 19 to 32 weeks gestation. Eight had normal
chromosomes, and three were aneuploid. The pulsatility index (PI) was
elevated (above the 90th percentile for gestational age) in 3/11 CHD
fetuses (P = NS). Elevated PI did not discriminate well between those with
fatal and nonfatal lesions. Although all three fetuses with elevated PI had
fatal disease, five of eight fetuses with fatal anomalies had normal PI
values. We conclude that, while umbilical artery PI values were elevated in
a subgroup of affected fetuses, this was not clinically helpful.
