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Any sonographers out there can reassure me re: placental doppler PI measurements???? ...

(3 Posts)
becaroo Sun 07-Sep-08 11:55:53

...I am now 38 weeks and I have been having serial growth scans as my last child had IUGR (basically the placenta stopped working).

Mu last 2 scans have showed the babys grwoth has slowed (from being top of 75th centile to below 50th) and the last 2 dopplers showed a measurement of 0.75 and 0.63 done only 5 days apart.

Is that OK? The blood flow to the baby seems to be reduced each time and I am worried. My amniotic fluid has also gone up again from being down last scan.

Am very confused....sonographer said it was OK, but what with my last child having IUGR and this babys growth having stalled I am very concerned. I have an antenatal appointment tomorrow - should I ask anything specific???


madmarriedNika Sun 07-Sep-08 19:40:26

Have had a few of these myself but not entirely clear either...

I have read that there is some evidence that as gestation increases PI decreases, so that might be why...

Also found some info that says: "In the complicated pregnancies, significant correlation was found between abnormal perinatal outcome and abnormality of the uterine artery blood velocity waveform, either increased PI (n=44) or a notch in early diastole (n=92). "
So again decreased PI might actually be normal or a good thing...
see: "Albaiges et al. used color Doppler to examine the uterine arteries in 1757 singleton pregnancies attending for routine ultrasound examination at 23 weeks 17. Increased impedance was observed in 7.3% of patients, including 5.1% with mean pulsatility index of more than 1.45 and 4.4% with bilateral notches. Increased pulsatility index identified 35.3% of women who later developed pre-eclampsia and 80% with pre-eclampsia requiring delivery before 34 weeks; the respective values for bilateral notches were 32.3% and 80%. The sensitivity of increased pulsatility index (PI) for delivery of an infant with birth weight below the 10th centile was 20.9% and 70% for birth weight below the 10th centile delivering before 34 weeks; the respective values for bilateral notches were 13.3% and 50%.

These findings suggest that a one-stage color Doppler screening program at 23 weeks identifies most women who subsequently develop the serious complications of impaired placentation associated with delivery before 34 weeks. The screening results are similar if the high-risk group is defined either as those with increased PI or those with bilateral notches."

Hopefully someone who knows more will come along soon- otherwise do ask for a full explanation of the numbers tomorrow.
I think that an increase in amniotic fluid (so long as not too much) is a good thing, with IUGR they often worry about low amniotic fluid as that's sometimes a sign of poor blood flow from placenta.

It is only natural to worry with your previous experience but remember growth measurements are never fully accurate from scans... I am sure if they're worried by the slow down in growth rate they'll keep a close eye on you.

Good luck x

becaroo Mon 08-Sep-08 09:50:26

Thanks Nika - will be asking lots of questions this afternooon!

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