Color Doppler ultrasonography assessment of uterine artery hemodynamics and fetal growth parameters for predicting adverse pregnancy outcomes

Han Xu; Yu Ziyang; Sun Baiyun; Wang Zhongjie; Xing Wen; Xiang Xuebing; Deng Qicheng

doi:10.11986/j.issn.1673-873X.2025.07.15

Abstract：Objective To investigate the predictive value of color Doppler ultrasound assessment of uterine artery hemodynamics and fetal growth parameters for adverse pregnancy outcomes(APO).Methods From February 2022 to February 2025,120 parturients who underwent prenatal care and delivery at the Second Affiliated Hospital of Soochow University were enrolled.According to pregnancy outcomes,patients were assigned to a good outcome group(n=86)and an adverse outcome group(n=34).General clinical data,mid-and late-pregnancy uterine artery hemodynamic indices[pulsatility index(PI),resistance index(RI),systolic/diastolic peak flow velocity ratio(S/D)]and fetal growth parameters[biparietal diameter(BPD),head circumference(HC),abdominal circumference(AC)and femur length(FL)]were collected for univariate analysis.Pearson correlation analysis was used to examine associations between APO and changes in uterine artery hemodynamics and fetal growth indices;receiver operating characteristic(ROC)curve analysis was applied to evaluate predictive value.Results In mid-pregnancy,there were no significant differences between the two groups in PI or RI(P＞0.05).The S/D ratio was signif-icantly higher in the adverse outcome group than in the good outcome group(P＜0.05).In late pregnancy,PI,RI,and S/D were all significantly higher in the adverse outcome group than in the good outcome group(all P＜0.05).In mid-pregnancy,there were no significant group differences in fetal BPD,AC,or FL(P＞0.05),whereas fetal HC was significantly lower in the adverse outcome group than in the good outcome group(P＜0.05).In late pregnancy,BPD did not differ significantly be-tween groups(P＞0.05),while HC,AC,and FL were all significantly lower in the adverse outcome group compared with the good outcome group(all P＜0.05).ROC analysis indicated that late-pregnancy PI had the best predictive value,with an area under the curve(AUC)of 0.962.Conclusion Pregnancies that developed APO showed higher PI,RI,and S/D and lower fetal HC,AC,and FL of the uterine artery in late pregnancy,with higher S/D and lower HC already evident in mid-pregnancy.PI,RI,and S/D were positively correlated with APO,whereas HC,AC,and FL were negatively correlated.Late-pregnancy PI provided the best predictive performance for APO.These findings may help clinicians identify women at high risk for APO,particularly in mid to late gestation,and may,to some extent,enable the prevention of APO in women identified as at risk in mid-pregnancy.