Doppler velocimetry and placental disease.

Quantitative placental examinations were performed on 47 women who had Doppler flow velocity studies of the umbilical artery during their pregnancy. The systolic-diastolic ratio of the umbilical artery was used as the measurement parameter to divide the study population into two groups. Group 1 consisted of women with normal systolic-diastolic ratios (systolic-diastolic less than 3), and group 2 consisted of women with an elevated systolic-diastolic ratio (systolic-diastolic greater than or equal to 3). The group with an increase in systolic-diastolic ratio had more perinatal complications as demonstrated by two stillbirths, a higher incidence of cesarean deliveries for fetal distress, and more admissions to the neonatal intensive care unit. Significant differences were found when gestational age at delivery, placental weight, birth weight, and the number of small muscular arteries in the placenta were compared. Since gestational age may have accounted for the difference in placental findings, patients were matched for gestational age. The placental weights were comparable, but there were fewer small muscular arteries in those patients with an increase in systolic-diastolic ratio (p less than 0.001). In addition, when these findings were examined to determine the influence of diminished uterine flow velocity, none was found.