Double notches: association of uterine artery notch forms with maternal outcome

Objective

To assess uterine artery Doppler waveforms and notches performed in the third trimester as a predictor of adverse outcomes.

Methods 

Of 490 pre-eclampsia patients between 24 and 34 weeks gestation, 166 were diagnosed with mild pre-eclampsia and 324 were diagnosed with severe pre-eclampsia. Patients with complete data were divided into four groups as patients with no notch (n:58), a unilateral notch (n:93), bilateral notches (n:252) and double notches (n:39).

Results 

Bilateral and double notches were predictive of shorter follow-up times, adverse laboratory outcomes (mean 24 h proteinuria, AST, LDH levels) and HELLP syndrome, need for magnesium sulphate treatment, higher systolic and diastolic blood pressure (Table 1 and 2).

Conclusion 

Bilateral notches and especially double notches represent progressive deterioration in the uterine artery and are predictive of adverse maternal outcomes.

Keywords

Pre-eclampsia, double notches, maternal outcome

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	Table 1 Dunn’s multiple comparison test for uterine artery between groups Group 1: Patients without notch; Group 2: Patients with unilateral notch; Group 3: Patients with bilateral notches; Group 4: Patients with double notches
	Table 2 Maternal outcome related with uterine artery waveform (n: 442)