Volume 164 Number 1, Part 2

312 DOPPLER BLOOD VELOCITIES IN TI-lE FIRST TRIMESTER OF PRE<?l'IANCY Angela Sharkeyx. Gerald Tulzerx, James Huhta, University of Pennsylvania, Children's Hospital 01 Philadelphia. Philadelphia. Pennsylvama Cardiac Inflow(IF) and outflow(OF) velocities in the

normal human fetus have been shown to Increase In a linear fashion with increasing gestational age (GA) in the second and third trimester of pregnancy. Umbilical artery pulsatllity index decreases in a linear fashion with increasing GA. Eight patients from eight to 13 weeks gestation were examined using two dimensional and color directed pulsed wave Doppler after obtaining informed consent. Maxi mal Doppler velocities of IF. OF and UAPI were assessed for each fetus. These values were compared to second and third trimester fetuses. Doppler velocities and UAPI during the first trimester of pregnancy were significantly different (p<0 .0005). Trimester First Second Third

n 8 52 54 IF (cm/s) 33.4±9.5 46±7.3 55.3±9.2 OF(cm/s) 302±5.4 58 .5±14 .4 83±18.1

UA PI 2±0 34 1.4±0 .31 1±0.2 First trimester Doppler information requires correlation with the age of the fetus . Absent end­diastolic velocity In the UA may be normal in the first trimester. The rate of change of these Doppler parameters may be different early in gestation.

313 HYroXIA CANlUl' BE rEl'EClID BY '!HE UMBILICAL SjD RATIO IN FETAL ~ JA OOPEL, B ~, R ~*, JC lDBBINS, :EW NA'IHANIEI.SZ DEPl' Offi/GYN, YArE, NEW HAVEN cr; lAB ~ & NEWB:lRN RES, <XlRNEIL, l'IHACA NY

We stu:lied the effect of hypoxia on lUIi:lilical arteIy Iq:pler SjD ratios in fetal lanils. An experiJnental groop (~) had catheters placed, followed by 10 days of umbilical arteIy miCJ:'ClSIilere embolization sha!IIl to reduce fetal weight by 20% at tenn. Controls (C) had catheters placed am were stu:lied 10 days later. studies were done umer anesthesia (2% halothane in 02). Baseline fla.r, AOO I S am Iq:pler were obtained, then the e'i¥'e was given 5 minutes of la.r (10 I/min) am high (16 I/min) fla.r nitrogen with a ret:XNery period in between. Mean fetal ~2 drq:p:!d significantly (C: 21.5 to 18.5, am 15.2; Emb: 22.5 to 15.5 am 10.6). Fetal PI was urrharged. Mean baseline SID in C was 2.17, am in Emb was 2.8 (p = NS). Hypoxia did not dJange SID (la.r fla.r: C 2.04, Emb 2.32; high fla.r: C 2.35, ~ 2.65). conclusions: significant brief fetal hypoxia does not dJange SID in nonnals, or those with placental damage. Umbilical SID may not be an efficient way to detect t:.e:rrporary fetal hypoxia. (HD21350)

SPO Abstracts 331

314 CLINIC.Ii. SIOOnCNO: CF nIE DlcxrrIC r<7lOI IN GISTATlCIW. H'lPemNSI<I' wi! R. S«ld.ana. M.D •• tLai Jiq. H.O •• Deborah Ulm, RII6 .

BetMW Hospital, C1ncuraati, Chio. l&\

" The lni~5S of utert.~ flaw ~ been sblwn by others: nw clinical correlates of the dlC.roUC notch 1n PtH 15 presented. Ho\1DUAL" 1€'llID): 12) PlH patients had \nbillcal and utuine flaw by pulsed Doppler. The dicrotic notch was the iMependent variable and was corre1ated with the var1.ables listed in ~le I. RfSJLlS: table 1 depicts the results of chi!: stu:jy.

DlalJI"lC ~ .., r<7lOI P VAWE 01:57 0b66 OU~

Im'UNE SID ~ 2. 7 lEFr SIIE 26(4SY,) 9 (147.) <. 0 .001 Rlarr S1!£ 38(66%) 15 (23'1.) < 0.001

1..HilLlCAL SID ~ 3.0 19 (33'4) 8 (127.) < 0.01

C/SECrI<I' 41 (727.) 26 (J9'I.) < 0.01 ~ RAn: AfN»!AL 35 (617.) 19 (29'L) ..c. 0 .05 ITIAL 01= 27 (47'4) 19(29'LJ < 0 .05 Aro\R S<nlE <. 7 (1nnn) 19 03'1.) 5 (87.) < O.OCH SG< 26 (467.) 9 (147.) < 0.001

HLgl"er abnornsl U'l'bLhcal & utenne SID rat l OS were assoclAted Wlth a dlcrotlc ootc.h . A Slgnlhcantly hlgher rate of fetal distress, cesarean bHths. neonatal depressIOn ard poor fetal growth -...ere asSOCLated W1.th a dic rotiC rotc.h. <UQlJSl<N$; 'Ute utenne dlcrotlc notch 1n gestatlonal hypertens iOn can dlffecentlate the fetus at hlgher nsk for penMtal lTIOn:ad1ty. Poor plac.ental perfUS10n W"lth the c.orollary of fetal growth retardatlOn may be inferred by the utenne diCrotic. notch.

1. Schulnan, H.; The Chmc.al lnflhc.atlons Of ~ler Ultra.so.n:l AnalYS1S Of The Utenne And UTblllc.a1 Artenes. 1m. J. Cbstet. Cyre:01. 1S6:889 . 1987. 2. ~ll, S.,et .al., QJahtatlvc AsseS3rent Of Uteroplacent.al Blood FlOlol. tbstet. Gynecol.68 .649.1966.

315 UMBILICAL AND UTERINE ARTERY DOPPLER VELOCIME­TRY DURING MATERNAL EXERCISE . Allen SR, Frentzen BH

x, Hall DH

x, Cruz AC . Univ. of FL.

To evaluate the acute effects of maternal exercise on uterine and umbilical artery blood flow patterns, Doppler velocimetry was used before, during, and after exercise in 13 healthy gravidas (GA 29±6 wks) . Exercise consisted of a 5 min braked ergometer (ERG) warm-up, weight training (WT) workout (10-12 Nautilus machines), and a final ERG ride (5-20 min, 50-75 W), with a heart rate goal of 60-75% predicted maximum for age (~140 bpm) . Continuous wave Doppler US was used to measure SID ratios for the umbilical (UmbA), left (LUtA) and right (RUtA) uterine arteries.

UmbA SID RUtA SID LUtA SID Baseline 2.87+1.02 2.00+0.73 1 . 73+0.27 WT 2.48+0.64 ERG 2.47+0.49 Recovery 2.62±0.60 1.86±0 . 57 2 . 15+1 . 19 All comparisons above not significant, p>O.OS . Summary: 1) SID ratios were unaffected by exercise. 2) SID ratios for sedentary women were not different from those who exercised regularly. 3) SID ratios did not change over a 10 wk interval for 6 women tested twice . Conclusion: Submaximal WT and ERG exercise do not alter uterine and umbilical blood flow patterns as measured by Doppler velocimetry .