Early diastolic notch for prognosis of unfavorable pregnancy outcome

Daiva Simanavičiūtė

Clinic of Obstetrics and Gynecology, Kaunas University of Medicine Hospital, Lithuania

Key words: hypertension, pregnancy, Doppler, diastolic notch.

Summary. Objective. The appraisal of the sensitivity and the specificity of unilateral and bilateral or severe early diastolic notchs for prognosis of unfavorable pregnancy outcomes.

Patients and methods. The clinical study was performed in Kaunas University of Medicine Hospital. Two hundred thirty one patients with pregnant chronic hypertension or pre-eclampsia and 229 healthy pregnant women were involved into the study. The occurrence of early diastolic notch was compared between the groups. The sensitivity and specificity of unilateral and bilateral or severe early diastolic notches for prognosis of unfavorable pregnancy outcome was evaluated.

Results. The sensitivity of bilateral early diastolic notch for prognosis of various unfavorable pregnancy outcomes was 64.5–70.6%, and the specifińity was 71.9–79.7%. The sensitivity of unilateral early diastolic notch for prognosis of unfavorable pregnancy outcome was 78–90%, the specificity was 50–58%. The sensitivity of severe diastolic notch was 20–29.4%, and the specificity was 91–95.2%. Conclusions. The finding of bilateral early diastolic notches in the uterine artery Doppler velocimetry waveforms is a sensitive method for prognosis of unfavorable pregnancy outcomes in hypertensive women. Severe diastolic notch is more specific, but less sensitive method in comparison with bilateral early diastolic notches. The unilateral early diastolic notch has low specificity for prognosis of unfavorable pregnancy outcome.

Correspondence to D. Simanavičiūtė, Clinic of Obstetrics and Gynecology, Kaunas University of Medicine Hospital, Eivenių 2, 3007 Kaunas, Lithuania. E-mail: daivsima @hotmail.com

Received 17 February 2003, accepted 14 May 2003