Color Doppler Ultrasound Parameters of Fetal Umbilical Artery and Middle Cerebral Artery Assist in Diagnosing Hypertensive Disorder of Pregnancy and Evaluating the Severity in Women of Advanced Maternal Age.

OBJECTIVE

This study investigated the clinical significance of fetal umbilical artery (UA) and middle cerebral artery (MCA) Color Doppler parameters in the prenatal diagnosis of hypertensive disorder complicating pregnancy (HDCP) in pregnant women of advanced maternal age (AMA).

METHODS

AMA women with HDCP (245 gestational hypertension cases, 193 mild preeclampsia, 152 severe preeclampsia) and 80 healthy AMA pregnant women (control) in the late stage of singleton pregnancy were enrolled. Fetal UA and MCA Color Doppler parameters (systolic-to-diastolic ratio [S/D], pulsatility index [PI], and resistance index [RI]) were recorded. Influencing factors, and diagnostic and predictive value of these color Doppler parameters for HDCP and disease severity were assessed by logistic regression models and receiver operating characteristic curves.

RESULTS

Total bilirubin, total protein (TP), creatinine, Cl-, and antithrombin III (AT-III) closely correlated with HDCP severity. Fetal UA S/D, PI, and RI values increased while MCA S/D, PI, and RI values decreased with the worsening of HDCP. Fetal UA S/D, MCA S/D, and MCA RI were independent influencing factors for HDCP occurrence, while fetal UA RI, MCA S/D, and MCA PI were independent influencing factors for HDCP severity. The combined detection of these parameters demonstrated superior predictive value for HDCP occurrence and severity than individual parameter detection.

CONCLUSION

This study identifies several fetal UA and fetal MCA Color Doppler ultrasound parameters as potential influencing factors for HDCP occurrence and severity. The combined detection of these parameters may provide a reference for early recognizing HDCP and evaluating severity in women of AMA.