The value of umbilical artery Doppler to predict pregnancy outcome in patients with velamentous cord insertion

Objective To evaluate the role of umbilical artery Doppler ultrasound as a predictive marker of pregnancy outcome in patients with velamentous cord insertion (VCI). Methods The prenatal color Doppler ultrasound findings and clinical data in 90 patients with singleton pregnancies with clinically and pathologically diagnosed as VCI were retrospectively reviewed. The cases were divided into elevated S/D group and control group according to the ratio of peak-systolic to end-diastolic blood flow velocities (S/D) in the umbilical artery. Maternal characteristics, birth weight and incidence of adverse pregnancy outcome were compared between groups. Results The S/D of umbilical artery were elevated in 21 cases and normal in 69 cases. Mean birth weight in elevated S/D group (2603.8±834.5) g was lower than those in control group (3164.0±436.6) g, and the difference was statistically significant (P0.01). In elevated S/D group, the incidences of emergency cesarean section caused by fetal distress (9/21,42.9%), preterm birth cases (7/21,33.3%), small for gestational age infants (10/21,47.6%) and low Apgar score (4/21,19.0%) in elevated S/D group were higher than those in the control group with statistically significant difference (P0.01).Conclusion The S/D of umbilical artery is recommended to be used as an effective predictor of pregnancy outcome in diagnosis of VCI during prenatal ultrasound examination.