Uterine Artery Doppler PI results abnormal at 20 weeks

[fleur89]

Feeling really worried as this is my triple rainbow baby and based on my uterine artery PI results I'm classed as high risk going forward. Baby is growing on track at the moment but I'm really anxious about these results. Seems the right uterine artery is over working and the left one is under working? Can anyone help interpret these results?

Hi there @fleur89 . Congratulations on your pregnancy! I’m sorry you’re going through this anxiety after already experiencing losses. I had two miscarriages in a row and then also had high uterine pi readings so I know what it’s like!
it sounds like no one’s talked you through what all this means yet, or at least not in any detail. High uterine artery pi at 20 weeks is relatively poorly understood but is correlated with an increased risk of pre eclampsia and poor fetal growth later in pregnancy. However, at the moment your baby is completely fine, and there is a good chance you will go on to have a completely uneventful pregnancy. Even if there are issues further down the line they may be something like developing pre eclampsia and needing to be induced at, say, 36 or 37 weeks, or baby not growing so well at a similar point and being delivered early as a precaution. In other words, not ideal, but not disastrous either. The increased monitoring will make sure that any signs of these sorts of problems are picked up and acted on so you and your baby will be safe. In more extreme cases growth problems can manifest earlier and be more extreme, but this is not common and it’s not very likely at all in your case. The reason I say that is that whilst your right UtA PI is pretty high, your left UtA pi is very good. (Low UtA pi is a good thing!) What this means is that the average pi of the two arteries is actually within the normal range. When I was going through this I read a ton of studies in medical journals and several of those would have excluded you from their study group on the grounds that your combined/average reading was ok (in other words, some of the medical studies would have categorised you as normal!) I’m not saying you don’t need to worry at all, and it’s right that they’ll monitor you more. My point is that you are at the low risk end of the high risk category, so your chances of an extreme outcome are very small, whilst your chances of a good outcome are pretty high. My own higher reading was almost identical to yours, but my lower reading was around 1.20, so quite a bit higher than your lower reading. I had zero problems for the rest of the pregnancy and gave birth to a lovely little girl at almost 42 weeks!
I don’t know how much of a worrier you are, or how you stand financially. If you are very anxious and you can afford a private scan I’d recommend getting one that looks at UtA pi (choose a consultant led clinic) at around 26-28 weeks. If the higher reading has more or less normalised by this point your risk falls further (though is still elevated, so you’ll still need monitoring), which might help you mentally. There’s some limited evidence that yoga can help. Might be total guff but worth a try! Most importantly, try not to think about it too much, and try to get back to enjoying what will hopefully end up being a lovely pregnancy.
I hope all that’s fairly clear! If you have any questions I can try to answer. I found the lack of good info really frustrating when this happened to me, so I did a lot of research.

Thank you so much for your reply, it's really helpful. Really reassuring to hear you had no further problems in your pregnancy and congratulations on the birth of your healthy baby girl.

Just as I was leaving the room the nhs doctor told me as a "by the way" that she'll put me down as high risk due to elevated resistance in my uterine artery. I asked what this meant and she said additional scans from 28 weeks to make sure no issues with growth. Left with my head spinning as I'd only just been discharged from my recurrent miscarriage clinic 2 days earlier.

That's all she told me and I've been Googling ever since the report came through. You're right, it's hard to find much information on this. I saw the study about yoga so am going to do more of that. Also thinking to eat more protein to help boost the baby's weight and perhaps have some massages and eat pomegranate (don't like beetroot!). Anything I can action myself will help manage my anxiety and none of these things carry risk so I may as well try it.

Upon your advice I've booked in a private scan with a leading consultant around 25/26 weeks for reassurance 🙏

Wondering if there's anything you tried that you think may have helped? Either to manage your worries or reduce your pi results. Also were you told you're okay to fly? I have a couple of trips coming up at 23/24 weeks and 27/28 weeks.

I forwarded my report onto my recurrent miscarriage consultant yesterday afternoon who said I shouldn't worry too much as my BP is normal and Papp-a readings were normal, so the Doppler study is just one marker and I'm okay to fly. I also forwarded my report onto the consultant I'll be seeing at 25/26 weeks and his secretary said he'd review it early next week xxx

It’s so hard, isn’t it? You’re just starting to think you can relax, and then you get thrown this curve ball and there isn’t even any easy to access information available. Flying wasn’t on the cards for me as my pregnancy was during the COVID years but I can’t see why it would be a problem, especially at that point in the pregnancy, so long as the growth scans show baby’s growing well and your blood pressure is normal.
I relaxed quite a bit when it turned out my readings had normalised by 26 weeks, and a lot once I started to feel my daughter’s movements regularly. I was told that, most of the time, a wriggly baby is a healthy, growing baby, so if movement is strong and regular it’s very reassuring. Have a talk to the private consultant about it and get him or her to be clear about outcomes and probabilities. Oh, and enjoy the private scan. They’ll probably use the amazing 3D scanning tech and you’ll see baby really well!