Double notches: association of uterine artery notch forms with fetal outcome and severity of preeclampsia

Objective

To assess uterine artery Doppler waveforms and notches performed in the third trimester as a predictor of adverse outcomes.

Methods 

Of 490 pre-eclampsia patients between 24 and 34 weeks gestation, 166 were diagnosed with mild pre-eclampsia and 324 were diagnosed with severe pre-eclampsia. Patients with complete fetal data were divided into four groups as patients with no notch (n:53), a unilateral notch (n:78), bilateral notches (n:219) and double notches (n:39).

Results 

Bilateral and double notches were predictive for prematurity, lower 1st minute Apgar scores, higher need for neonatalntensive care unit admission, and perinatal mortality (Table 1 and 2).

Conclusion 

Double notches represent progressive deterioration in the uterine artery and are predictive of adverse fetal outcomes.

Keywords

Pre-eclampsia, double notches, fetal outcome

	File/Dsecription
	Figure 1 Typical pattern of “double notches”: systolic notches are marked with white-blue and early diastolic notches with black-blue arrows.
	Table 1 Fetal outcome related with uterine artery waveform (n: 380)
	Table 2 Dunn’s multiple comparison test for uterine artery between groups Group 1: Patients without notch; Group 2: Patients with unilateral notch; Group 3: Patients with bilateral notches; Group 4: Patients with double notches