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© 2002 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 21:857-860 • 0278-4297

Umbilical Artery Doppler Waveform Notching

Is It a Marker for Cord and Placental Abnormalities?

Alfred Abuhamad, MD, Annette J. Sclater, RDMS, Eric J. Carlson, MD, Richard P. Moriarity, MD and Maria A. Aguiar, MD

Departments of Obstetrics and Gynecology (A.A., A.J.S., E.J.C.) and Pathology (R.P.M., M.A.A.), Eastern Virginia Medical School, Norfolk, Virginia.

Address correspondence and reprint requests to Alfred Abuhamad, MD, Division of Maternal-Fetal Medicine, Hofheimer Hall, Suite 310, 825 Fairfax Ave, Norfolk, VA 23507.

Objective. To evaluate in a prospective, controlled fashion the prevalence of umbilical artery Doppler waveform notching and its association with cord and placental abnormalities. Methods. During a 6-month period, umbilical artery velocity waveforms were prospectively obtained on 1857 pregnancies at greater than 27 weeks’ gestation. All pregnant patients with the presence of a persistent fetal umbilical artery waveform notch formed the study population (cases). Control patients, matched for gestational age, with normal umbilical artery waveforms, were selected for comparison (2 controls per case). After delivery, detailed pathologic examination was performed on all umbilical cords and placentas. Results. The presence of an umbilical artery waveform notch was noted in 29 (1.6%) of 1857 pregnancies. Postnatal placental evaluation showed the presence of an accessory placental lobe in 5 (17%) of 29 cases compared with 1 (1.8%) of 54 controls (P = .018). Overall, the presence of an umbilical artery waveform notch was associated with umbilical cord abnormalities in 21 (72%) of 29 cases compared with 8 (14%) of 54 controls (odds ratio, 15; 95% confidence interval, 4.4–54.4). Conclusions. Umbilical artery waveform notching appears to be a strong predictor of cord and placental abnormalities. This finding may have important clinical implications.

Abbreviations: CI, confidence interval • OR, odds ratio

Key Words: cord abnormalities • Doppler imaging • notching • placental abnormalities • umbilical artery




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R. Hackmon, Y. Barnhard, K. B. LeScale, D. E. Luciano, A. Ferber, and M. Y. Divon
Is Notching in the Umbilical Artery Doppler Waveform a Benign Finding?
J. Ultrasound Med., November 1, 2005; 24(11): 1561 - 1564.
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Copyright © 2002 by the American Institute of Ultrasound in Medicine.