Any experience of abnormal uterine artery flow?

[Mumtotwofurbabies]

I’m currently 24+2 weeks pregnant, and am stressing (again!) I went for a routine growth scan as I’m high risk due to slight high BP at end of last pregnancy - worth noting growth was perfectly on track, baby movements are really good and reassuring, BP normal, no signs of pre-eclampsia. However sonographer identified that the PI resistance in one of the uterine arteries (forget which one) was over 95 percentile, mean was 1.78 and there was some notching. She initially just said this meant I would need an extra growth scan at 28 weeks to monitor. However I’ve been scaring myself with google searches on increased risk of pre eclampsia and IUGR…from having increased PI. my lovely consultant saw I was anxious and has slotted me in for a more detailed scan tomorrow afternoon with other consultant at the SGA clinic who knows a lot more about this. I’ve been anxious all the way through this pregnancy as it came after 2 miscarriages (and I have a lovely 3 year old). My worst fear is they say they have to deliver the baby really early or something. Just wanted to get this down and also ask for any other experiences! Sonographer wasn’t particularly pleasant as she quite bluntly said everything wasn’t ok, and then that she presumed I knew this would be a risk before I decided to get pregnant due to high blood pressure in a previous pregnancy (I didn’t know this would be a risk!!), but didn’t give me much extra info apart from the extra growth scan in 4 weeks time.

Uterine notching was detected at around 12 weeks, I had regular u/s scans from that point forwards. Scan at 28 weeks noted the flow was almost stopped, so they started steroid injections and told me to prepare for imminent birth. At 29+6 I was due a scan at 3pm but had felt no movement that morning, so the hospital told me to come in at lunchtime. DS was born at 7:40pm that evening, weighing just 1lb 6oz (around 635g in new money).

He was a fighter. He spent 11 weeks in NICU, and was discharged just two days after his original due date. You're bound to be thinking "But is he okay?" I'm afraid the answer is no; he is deaf, autistic, and has severe learning disability. But the first of these could have been caused by the antibiotics he received in NICU (gentamicin resistence), and the latter two could have been caused by a cranial bleed just before birth. So we don't know whether the uterine notching, and the IUGR, actually contributed to any of his disabilities. DS is now 12 years old and is the light of our life.

You're in safe hands. Trust that, and trust your body to tell you when things aren't right.

Incidentally, our story featured many years ago on the documentary Cherry Has a Baby

Thanks for sharing your story…so glad your little one is ok, he sounds like such a little fighter 😊. I will watch that doc as I love baby related programmes and also Cherry Healey 😂. If you don’t mind me asking, when did the IUGR start becoming apparent on scans?

Short femur length was noted at the 12 week scan, so for that reason (and because I was a geriatric mother) (and because I said I didn't want a test for Downs!) I was referred to a specialist consultant. It was at the specialist's 16 week scan that they said baby didn't just have short femurs, he was small all over and therefore probably IUGR from the notching.

I was told that if I decided to have another baby, then they'd recommend daily low-dose aspirin to improve blood flow. But DS was our one shot fr various reasons, so the situation never arose.

Are you on aspirin? I had a uterine artery Doppler at 16 weeks as I had high blood pressure at my booking appointment. That showed restricted flow and notches, the sonographer told me that it just confirms that I should be taking the aspirin as it helps with the blood flow. I have regular growth scans and now 33 weeks and so far all is good with baby measuring 50-60%. No signs of IUGR or preeclampsia, except the high blood pressure which I’m on labetalol for.

I did! I don't remember anything about notching, but the PI resistance in both arteries was higher than the cut off. I had growth scans at 28 and 32 weeks (the 36 week is standard in my trust anyway). I did go on to develop pre-eclampsia later in my pregnancy, but other than the blood pressure and protein, I was fairly symptomless. It was very bizarre having to stay in hospital when I otherwise felt fine! Baby was very well grown, and all the CTGs indicated she was perfectly happy inside. So it was OKed by the consultant to get to 37 weeks, then be induced. She's now a perfectly healthy, happy demon monster toddler.

Thanks everyone, I’m holding onto the fact that growth and absolutely everything else is normal as a good sign. @SW100 I’m already on 150 of aspirin a day, due to mild gestational hypertension in last pregnancy. That’s good that you have this as well and growth etc is normal I’m just a born worrier I think, especially in pregnancy. Jennifer that doc isn’t on BBC iPlayer anymore, will have a look on YouTube 😊

Thanks Dyra, that’s reassuring to know

Hi @Mumtotwofurbabies really glad I've found your post, I'm going through similar- am now 29+5 and when I went for my 20wk scan they picked up that both my uterine arteries were off the chart high so got referred for extra growth scans/hospital ante natal clinic.

28wk scan showed the centiles had all dropped down but consultant and midwife both say they are currently not worried. Was told I categorically can only give birth on the delivery unit - no midwife unit that I'd hoped for - as there's a risk of the placenta failing earlier and during labour, so I have to be monitored constantly and can only go a max of 1 week overdue. They will review things at 36wk scan but are still saying a natural birth is more than possible.

Sorry not much is the way of wisdom or useful info but you're not alone x

Oh am on 150 aspirin but was already on that due to family history of pre eclampsia, first pregnancy and have always had BP in the mid to high 120's /80's

@Mumtotwofurbabies I didn't expect it to be on iPlayer any more, it was over ten years ago! I know there are clips on Youtube, not sure if you'll find the whole show.

Incidentally following on from IUGR and stupidly low birth rate, our son has remained below the 0.4th centile for height at all checks. He grows steadily, just in proportion. It's not a problem given his other issues.

I had this with DS. I'd had 6 miscarriages between DD and DS and they identified a number of issues which meant I was monitored closely. At 30 weeks they told me flow had pretty much stopped on one side (intermittent?) and to prepare myself for an early birth and possible developmental delay/ Cerebral Palsy. The doc who told me was completely matter of fact and seemed surprised when I broke down. (Whole other rant there!)
Anyway went on anticoagulant medication and various other drugs and DS was born at 38 weeks weighing just under 4lbs.
He then ate for England. I was a size16 starting breastfeeding and a size10 after. He went from the bottom centile to the 90th, then levelled out at 50th by his second birthday. He's amazing. He is smart and funny and quite sporty. He has occasional right side weakness and tight tendons when very tired and the hospital toyed with a CP diagnosis (consultants couldn't agree!) but he plays sport almost daily and is managing fine.
The hospital think I probably had it to a lesser extent with DD (born at term at 5 lbs) and she does struggle a bit as she's got ADHD and apparently there's a slight link. However she's doing well now she's diagnosed.
Good outcomes are possible.

I had a suspected IUGR baby 10 weeks ago (my first). Nobody ever mentioned notching, but at my 12w scan the blood flow was identified as being poor. Prescribed 150mg aspirin and extra scans arranged. At 12w scan she was on 50th centile, at 28w scan she had dropped to 25th centile and at 36w scan she was on the 9th centile. Induction arranged for 39w but i had hypertension (155/110) and premature rupture of membranes at 38w.

Because of her size, i had a natural delivery suite delivery (although with no consultant involvement - midwife only and had really excellent care) so that she could have CTG monitoring. I was upset beforehand that I couldnt have a birth centre delivery, but actually on the day, i didn't care about that and the midwives were brilliant at 'de-medicalising' the delivery suite room and were happy for me to labour on cushions / mats on the floor rather than on the bed. When she was born, she was actually on the 2nd centile.

We had a tricky start as she had GBS sepsis and spent 2 weeks in NICU / SCBU but that wasn't caused by her size (although her size may made it harder for her to fight off the infection). We struggled with breastfeeding because her suck was very weak and she dropped to 0.4th centile but now back to 2nd since we went to combi feeding. She's long (50th centile for length) but just tiny in weight - we got to 4kg last week, which felt like a big achievement and has really been due to me just feeding her constantly! I'm only now able to relax about letting her go longer than 3hrs in the night. I really believe the asprin helped us get to 38w and the size we did, so fingers crossed it works for you. Good luck for the rest of your pregnancy.

I have a notch on my left uterine artery which was picked up as my previous baby was an SGA baby. I already had extra scans scheduled as he was 4th centile, however am also monitored more closely for preeclampsia due to the notch. I'm on aspirin every day and until 34 weeks had to see my midwife bi-weekly for urine and blood pressure, then from 34 weeks it has been weekly. So far there have been no issues and after my 36 week scan I was signed off by the consultant as they are happy with baby's growth so no need for the 40 week scan. I'm now coming up to 39 weeks and no issues so far, I had also been concerned about an early induction.

Thankyou so much everyone for your reassuring stories, I was panicking last night but this morning I’m feeling a little better, in the mindset that if the baby can just keep growing at a normal rate for the next few weeks I’ll be ‘safer’ in terms of if she has to be delivered early. Will let you all know what the consultant says for this going through similar. I’ve actually seen this consultant before and he is really nice and explains everything in detail (unlike the sonographer) so will hopefully feel reassured. She’s very active which is good. As I said I had high BP in my last pregnancy and my daughter was on the small side (born at 10th centile but now 50th) but the trust didn’t test for uterine artery flow then, so you never know, I could have had the same issue then but just been in blissful ignorance 🤷‍♀️

I was referred for a growth scan at 34 weeks due to no fundal height growth since last time. Growth was fine and baby was completely normal weight. However a high uterine Doppler reading was picked up (from memory it was around 1.4 which was over 95th centile). BP was fine and I had no other issues. From then on I had to have twice weekly scans to monitor these readings. They remained high the next few scans but then went down to a normal level. My consultant said if they were still high I would be induced at 37 weeks as a precaution. I continued to have growth scans and baby was a good size still. I was induced on my due date and she was delivered via emergency c section as she was in distress and I had unexplained bleeding. She was a healthy 7lb9oz 💕

@Mumtotwofurbabies my consultant said if you have a notch this time and the father is the same, then you would have had it with previous pregnancies as they don't just develop in subsequent pregnancies.

So just got back from the consultant appointment. He spent the first bit reassuring me that it wasn’t a problem, just slightly increased risk. Then did a scan and said actually that the uterine arteries (and everything else) actually looks completely normal! Feel a bit silly now lol. Strange that he and the sonographer got such completely different conclusions, but he was the consultant ‘expert’ in uterine Doppler for the trust so guess I trust him more. He was very thorough and mentioned that he had a lot of trouble getting one of the measurements as the artery was ‘hiding’ and scan took forever, whereas sonographer was very quick. Strange…but very reassured. 🤷‍♀️

Glad everything looks ok! Must be a relief. I remember from my first that there was a box with a PI value for the sonographer to use in the event they were unable to get an adequate artery reading. Maybe that's what they used rather than hunt the artery.