High resistance in umbilical artery 20 week scan

Golaz · 2023-10-04T08:37:38+00:00

Hi All, I went to my 20 week scan yesterday and they found high resistance in my doppler scan readings. My mean PI was 1.42 (over 95th percentile). I have a history of preeclampsia and a previous growth restricted baby so obviously this has sent me down an anxiety spiral. Does anyone have any experience of this that they could share? I already have extra growth scans booked for 28, 32 and 36 weeks, but I don't feel very reassured. Does anyone know how variable/ accurate these readings can be? My baby was moving a lot during the scan and apparently this can affect the results..? Please share any stories/ knowledge/ advice. TIA xxx

Lottie917 · 04/10/2023 10:22

I don't have direct experience of this but I had my 20 week scan yesterday and baby's head measurement was flagged as small. Been referred to fetal medicine so I completely understand that feeling of anxiety spiralling. Hopefully this bumps for you and I hope everything works out okay for your baby xx

Original poster

Golaz · 04/10/2023 12:08

Hi Lottie, thanks so much for your reply. So sorry for the stress you are going through too. It's so hard isn't it :(. I almost think it's quite cruel on women these days as we have so much information about all these different things that could be going wrong in pregnancy, but so little of it is in our control/has any kind of a solution, and so many of them turn out to be nothing to worry about in the end anyway. I really hope the latter is the case for both of us.
Good luck for your scan with fetal medicine. When will it be do you know?
xx

OP posts:

Lottie917 · 04/10/2023 15:15

@Golaz I was thinking this earlier, that sometimes we probably have a bit too much information. I know that whenever I say stuff to my Mum she's always saying they never had that when she had me.

Thank you, I've been told I'll hear from them within 2 days with details of my next scan and they did a TORCH blood test yesterday to rule out possible infections, which I'll get the results for in 5-7 days.

Have you got to wait for your next scan, or is there something they can do in the meantime?

I really hope we both get a positive outcome x

Redpanda21 · 04/10/2023 17:14

No advice but having the same. I think it’s your uterine ones which they read until 28 week scan.

My uterine dopplers were a mean of 1.81 (above 97th centile).

I see the consultant on Friday so will keep you posted as to what pathway they put me on and what advice I am given.

bookbathnap · 04/10/2023 20:45

I had this too and it freaked me out. It’s so hard not to spiral when you get told something like this. I’m having weekly PI readings now and some are a bit high, some are normal. The main thing to look for is EDF on your notes which means the flow of blood is constant. With me the high PI readings coupled with small baby triggered extra growth scans. Best of luck and try to just breathe. It apparently happens to 1 in 10 mums.

khaa2091 · 04/10/2023 20:58

The uterine Dopplers have not given anyone any additional information that wasn’t readily available from your history.
You have previously had a small baby related to pre eclampsia, this scan just confirms that you are at increased risk of it happening again.
Whatever happened, you would have been offered additional growth scans if your last baby was less than 10th centile.
I hope you are taking aspirin 150mg at night as it reduces the severity of pre eclampsia by helping the placenta to implant better.
Please don’t worry more, there is nothing new to be concerned about.
The uterine artery Dopplers are very different to the umbilical artery Dopplers that are used in later pregnancy to make decisions about timings of delivery and don’t get done after about 22 weeks.
(Can you tell I’m not a fan of uterine artery Doppler)

MustBeThursday · 04/10/2023 21:33

I had this with my first pregnancy. I had the growth scans at those weeks. For me pregnancy went smoothly and baby was 8lb 2oz. When I had my second the hospital I went to didn't measure it so I didn't have any extra monitoring.

Original poster

Golaz · 05/10/2023 11:19

Thanks so much for your responses everyone.

@Lottie917 I have everything crossed for you for your results, and hoping that you have some more information about your scan with foetal medicine asap xxxx

@Redpanda21 So sorry you are going through this stress too. Please let me know how it goes with the consultant tomorrow (only if you are happy to!)

@bookbathnap thanks so much for sharing your experience. How far along are you now? Strangely I can't find anything about EDF on my notes. What should the EDF reading be ideally?

@khaa2091 thanks so much for your insights. I didn't realise that uterine artery dopplers were different to umbilical artery dopplers, that's helpful to realise there is a difference. Can I ask why you say you are not a fan of the uterine artery doppler? Is this because they aren't accurate? (She says hopefully lol!) I have been taking 75mg of aspirin, but I think I am going to up it to 150mg. I haven't had a chance to speak to my midwife yet. I already knew I was high risk because of my history and already had extra scans booked due to this, but I think the reason why this has freaked me out even more as it's a test that provides information about what's happening in my body now with this particular pregnancy. IYSWIM. So given these readings and my previous history together, it feels very worrying.. 😞

@MustBeThursday thanks so much for sharing your experience, that's really reassuring to hear <3 <3

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bookbathnap · 05/10/2023 14:47

@Golaz I’m almost 32 weeks now. The EDF just says ‘present’ but doesn’t give a reading. Maybe ask at your next appointment.

Redpanda21 · 06/10/2023 11:44

@Golaz Back from my appointment with the consultant.
There’s a 50% chance of growth restriction which would be the main concern as baby might need to come out but might not depending on growth curve. Goal is to get to 37 weeks.
High BP leading to pre eclampsia could be helped with tablets so less of a worry as having fortnightly checks.
Everything will be closely monitored and I’ll have growth scans at 28, 32, 36 and 39 weeks. I will see someone after each growth scan so plans can be updated if needs be.
So really a see how things go over the next couple of growth scans kind of situation.

123deepbreath · 07/10/2023 00:59

I've got this too, I'm on 150mg Aspirin and have been since 12 weeks, got my next growth scan in a week and a half and then consultant appointment in 2 weeks to figure out a plan but the midwife I spoke to has said that at any point the arteries could dilated reducing the pressure and if everything was fine with the growth of LO and my blood pressure then they wouldn't worry too much it more a sign to be extra cautious and monitor the situation

khaa2091 · 07/10/2023 07:46

@Golaz - I’m not a fan because I find that measuring uterine arteries doesn’t alter my management. Everyone I have seen with raised Dopplers at the 20 week scan who has finished up with a small baby has been predictable - like yourself - from their history. There is a very standard pre eclampsia assessment for needing aspirin (the only intervention that can alter the outcome) that picks up the same group by asking questions.
Given your history of pre-eclampsia and a small baby nobody was ever going to say “you know what, the uterine artery Dopplers are fine let’s not bother doing any extra scans”. So what has measuring them actually achieved apart from raising your anxiety? (This is absolutely not the national policy, which is to introduce the test for everybody).
Your uterine arteries are the same as in your last pregnancy so it is really not surprising that they are raised as it’s the same blood vessel.
The umbilical vessels are specific to this baby, and not measured until later. By the way EDF (End Diastolic Flow) is measured in umbilicals, not uterines, and used to help make decisions about whether early delivery is required.
Apologies for going into so much detail, the overwhelming likelihood is that things will be better this time. Babies - even if small - tend to be bigger and pre eclampsia later and less severe in subsequent pregnancies.

Redpanda21 · 07/10/2023 15:15

@khaa2091 i had Doppler scan in my last pregnancy and my uterine arteries were fine and normal.

seven201 · 07/10/2023 19:20

In response to the potential upping aspiring bit - I had pre-eclampsia with my last pregnancy so was put on 150 aspirin this time. My age may also have been a factor in that. It's also best to take it before bed apparently.

Original poster

Golaz · 08/10/2023 14:08

khaa2091 · 07/10/2023 07:46

@Golaz - I’m not a fan because I find that measuring uterine arteries doesn’t alter my management. Everyone I have seen with raised Dopplers at the 20 week scan who has finished up with a small baby has been predictable - like yourself - from their history. There is a very standard pre eclampsia assessment for needing aspirin (the only intervention that can alter the outcome) that picks up the same group by asking questions.
Given your history of pre-eclampsia and a small baby nobody was ever going to say “you know what, the uterine artery Dopplers are fine let’s not bother doing any extra scans”. So what has measuring them actually achieved apart from raising your anxiety? (This is absolutely not the national policy, which is to introduce the test for everybody).
Your uterine arteries are the same as in your last pregnancy so it is really not surprising that they are raised as it’s the same blood vessel.
The umbilical vessels are specific to this baby, and not measured until later. By the way EDF (End Diastolic Flow) is measured in umbilicals, not uterines, and used to help make decisions about whether early delivery is required.
Apologies for going into so much detail, the overwhelming likelihood is that things will be better this time. Babies - even if small - tend to be bigger and pre eclampsia later and less severe in subsequent pregnancies.

Thanks so much for this information, it’s really helpful. Especially the clarification between the umbilical and uterine artery. So am I right in thinking that based
on what you said this doesn’t necessarily mean that there’s anything wrong with my placenta? Is it sort of like another measure of BP? I was crazy stressed the day of the scan and my BP was also very high, but has settled back down again now. Could this potentially have caused a temporarily raised reading? Sorry for all the questions, and completely understand if you don’t have time/ the knowledge to respond xx

OP posts:

Original poster

Golaz · 08/10/2023 14:11

Redpanda21 · 06/10/2023 11:44

@Golaz Back from my appointment with the consultant.
There’s a 50% chance of growth restriction which would be the main concern as baby might need to come out but might not depending on growth curve. Goal is to get to 37 weeks.
High BP leading to pre eclampsia could be helped with tablets so less of a worry as having fortnightly checks.
Everything will be closely monitored and I’ll have growth scans at 28, 32, 36 and 39 weeks. I will see someone after each growth scan so plans can be updated if needs be.
So really a see how things go over the next couple of growth scans kind of situation.

How are you feeling about it? That’s great you are having extra scans and they are not too worry about preeclampsia. Did they give you another scan or just discus results?
xx

OP posts:

Original poster

Golaz · 08/10/2023 14:14

seven201 · 07/10/2023 19:20

In response to the potential upping aspiring bit - I had pre-eclampsia with my last pregnancy so was put on 150 aspirin this time. My age may also have been a factor in that. It's also best to take it before bed apparently.

Thanks @seven201 . I’ve been taking in the morning but will switch to evening. My BP was really high for a couple of days , I don’t know if due to all the stress, but it’s come right down again 🤞🏻

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Redpanda21 · 08/10/2023 22:28

I feel okay. Hopefully the next scan will tell us a little more. That’s in 3 weeks.

I’m fine with having an early baby if needs be, it is what it is

Alisha1990 · 24/01/2024 13:49

Hello everyone,
i have been scrolling through the internet in a panic after my scan today, I am 17 weeks pregnant with twins, they want to see me again next week due to second twin having absent EDF, they wouldn't go into much detail with me and said this can change and for me to come back again next week. Baby is measuring ok @ 6oz but obviously now I am in a panic, can anyone give me some reassurance as I can't stop worrying!

Redpanda21 · 24/01/2024 23:40

@Alisha1990 try not to google. Could be babies are leaning on the cord.

Alisha1990 · 25/01/2024 11:49

Thank you for your reply, I'm trying hard to think of positives as baby is measuring 16+6 and I am currently 17+2 weeks. But it's going to be one hell of a wait until my scan next week.

PMB12 · 09/01/2026 16:04

Hi everyone. What happened in the end. We are in a similar situation.

Alisha1990 · 09/01/2026 20:20

PMB12 · 09/01/2026 16:04

Hi everyone. What happened in the end. We are in a similar situation.

Hi, I had issues on an off with this throughout my pregnancy, at one stage they thought I may not make it to 32 weeks, but with close monitoring I made it to 36 weeks. It was a stressful time but I now have 19 month old healthy boy/girl twins. Wishing you all the best, I'm sure everything will work out just fine

123deepbreath · 13/01/2026 21:23

@PMB12 I was very very closely monitored with scans every other week and NSTs in the middle week - made it to 39 weeks before the doctors said enough is enough now but from 37 they were being very cautious, one more bout of reduced movements would have had her out earlier but she behaved herself! Induced me which went brilliantly!

Born at 6lbs 9oz and dropped to 5lb 6ozs at a week then took an age to put weight back on but now shes the most chaotic whirlwind of mischief i've ever met!