Uterine artery Doppler PI identical for both?

[randommangoandpear]

I keep coming back to this issue. Not only is it off the charts high (not good!), it seems highly unlikely to me that both readings would be IDENTICAL. I feel a mistake has been made, meaning the result could be even higher. If so, that means I should have extra monitoring.

I posted about this before, I had the Doppler because my first was born small.

Am I just being paranoid? How can both be exactly 1.14??

A uterine artery Doppler is essentially just a screening tool for growth restriction. You can’t treat an high uterine artery Doppler it just triggers additional surveillance, in my trust that would mean a 28/32/36/39 growth scanning schedule. If it’s a high it’s high, there is either normal or abnormal so the numbers don’t really matter if that makes sense, once it’s outside the normal range everyone is offered the same surveillance it isn’t dependant on the number

@Overthehill123 They said because combined it is under 2.5, it is not classed as abnormal and therefore I don’t need a 28 week scan.

Frankly, I am feeling very upset. At booking aspirin was recommended, but my consultant said it wasn’t necessary as my first was borderline small and not IUGR. Now I feel like I’ve damaged my unborn baby and am risking their life all because I didn’t take aspirin.

I see that’s interesting, I suppose all trusts work differently. There’s nothing to suggest any damage is being done so try not to stress yourself. Did this baby’s estimated weight fall into the normal category during this scan?

@Overthehill123 Thanks for the reply.

it did, everything around 30-45th centile, except abdomen which was 75th!

thats really reassuring, your midwife should measure your fundal height and any concerns that should trigger additional growth scans. Just tell yourself that even without aspirin, your baby is growing really well at present and AC measurement is a really good indicator of growth restriction so the 75th centile is excellent, I understand it’s anxiety provoking but they must be reassured by what they are seeing🙂

Today I received a consultant appointment for 4 weeks time. Confused as I hadn’t yet received my 26-28 week scan appointment, I rang up to find my referral was CANCELLED as the registrar I had my appointment had spoken to the consultant and it had been decided that my uterine Doppler readings are normal and therefore I don’t need the extra scan.

I’m pretty furious and upset. They weren’t planning to tell me this until the appointment in 4 weeks, despite discussing all the risks associated with high uterine Doppler readings last week at my appointment.

Further to this, the readings ARE high. They are just under my trusts threshold of a “combined 2.5 PI.”

I don’t know what to do or think.

My trust's threshold is also equal or above 2.5 combined PI
Yours, as per the picture, are 2.28. It is possible this is a high reading, may I ask what's your point of reference ?
As for your first baby, it seems like the goal post is constantly moving where "normal" weight is concerned. Your consultant said they were not small, why do you think they were?
Aspirin as a preventative measure for improving blood flow only works around 15% of cases leaving a high margin for it not doing anything so please do not feel guilty for not having taken it. Were you told to take it this time around too?
Other than preeclampsia and gd, what other risks are there with high uterine doppler? Would many other groups not be at risk of those too?

I would be annoyed too that they cancelled the referral without telling you, but nothign surprises me about maternity services these days. They are understaffed and overworked, like many of us.

What do you plan on doing?

FYI my PI reading was of 2.6 at my 20 week scan and I went to have a private scan done two weeks later.

@NatGee According to the information available online, anything above 90th centile is abnormally high. Mine is off the charts high.

Re aspirin, the midwife flagged it, first consultant said no need, then seemingly second consultant thought I should have been taking it all along.

Can I ask what made you choose to go for a scan 2 weeks later? I had decided this afternoon that I’d just go for a private scan instead but had thought about going at 26 weeks.

@NatGee And high PI increases risk of preterm labour, stillbirth etc, all the worst outcomes. So, for them to just CANCEL and pretend they didn’t tell me all of this…. Pfft. Also, regardless of them cancelling, it is still high. There’s no changing that.

@randommangoandpear I had a second scan done because, like you, I wanted to make sure I wasn't being fibbed but also wanted to see if lifestyle changes improved the results. What my consultant said was that the resistance or PI should decrease as the pregnancy progresses. Her language was also pretty scary telling me all the worst outcomes, in my case, she was surprised I am not on hypertension medication or that I havent got GD. She said I am "at risk" of iugr due to placental insufficiency however Ive since learned that high risk or at risk is not a diagnosis. Baby is growing fine. And by the sounds of it, so is yours.
Look after yourself and your health - eat well (if you haven't yet, look into the brewers diet), exercise, I have begun doing acupuncture, and remove as much stress from your life as possible. Sounds simplistic but your body is doing what it is meant to and until you are told youve got something then I wouldnt let that stress you out. I am sorry for the opinion bit, I hope it doesnt offend. Good luck

@NatGee Thanks for the reply. I’ve had a look at the main scanning places here only seem to do growth scans from 26 weeks, otherwise I’d do the same as you.

did you see your PI reduce at the private scan?

Yes. it went down to 2.36 combined. may have gone back up cos Ive been on holiday and slacked.
I wasnt that far gone back then, I just went for an abnormality scan and asked the sonographer to do a colour doppler on my arteries which she did. She took all the measurements too so the growth was nicely plotted against centiles much like the nhs'

@NatGee When you say you slacked, I can’t find any literature to suggest you could influence this kind of thing apart from the obvious one - smoking!

Glad is all ok for you now.

why is smoking an obvious one, did you find any literature on it?
And what sort were you hoping to find, on the topic as a whole, a medical paper or a study?

@NatGee Yes, smoking kept coming up. More specifically, nicotine affecting blood flow to the placenta.

I read through a lot and couldn’t find anything suggesting you could “bring this on yourself” apart from this. I hope you’re not blaming your lifestyle in any way.

I have low blood pressure, don’t smoke, and had my 12 weeks scan today and my right is 1.16 (interestingly shows on mine as very low) and left is 2.89 (so way higher - but they weren’t too concerned at this stage and something they’ll just monitor)

@redxlondon how come they did it at 12 weeks? I thought they only did it from 20 weeks onwards

No idea, I didn’t realise it wasn’t typical

I didnt even know it was a thing so when it got done, I was so confused I thought she was listening to the baby's heartbeat but it was so slow that it couldn't be it. In fact, this was not done in the routine scan for me. I had to be referred to the consultant for something else and she did it.

In response to your comment @randommangoandpear you're right, there's v little literature out there in regards how to treat it, aspirin really being the only accepted method to try and prevent the complications brought on by a poorly serviced placenta. I read a study in which 100 women or so whose PI reading was taken, of those, a small percentage (13% if i remember correctly) were found to have high readings and from that pool, 60% went on to develop preeclampsia. My thinking is a few things are akin to smoking in their effects on the body mainly our heart and circulatory system like poor diet, sedentary lifestyles etc so if not smoking is meant to help then lifestyle changes like clean eating and exercise must help too.