Raised Uterine Arteries Pulsatility Index & Resistive Index

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Raised Uterine Arteries Pulsatility Index & Resistive Index

Postby Miss406 » Wed May 25, 2016 1:57 pm

Just want to put a post out there for support and advice with regards the above topic.

I had my 20 week scan on Friday (I was 20+5) and I have a raised uterine arteries pulsatility index and resistive index.

Just wondering if there are any other ladies out there that also have this complication?

Apparently, the baby is at risk. The main risks are a low birth weight (makes sense as my firstborn was only 5lb 9oz) and pre-eclampsia in later stages.

I am already on 75mg aspirin daily because of an increased Pre-E risk prior to finding out about this.
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Re: Raised Uterine Arteries Pulsatility Index & Resistive In

Postby inthemetro » Sun Jun 05, 2016 3:50 pm

Hi Miss. I'm in a similar boat. I'm pregnant with twins. My little boy is healthy (and is in fact big for dates), but my little girl has what I think is the more severe stage of what you're talking about. The doppler of her placenta at just over 24 weeks determined that her EDF flow is absent--which basically means the resistance is stronger than just being raised, and her placenta is really not functioning correctly. She's also very small (she's IUGR, and is at the very bottom of the growth charts). As terrifying as it is, at least she's still growing and her fluid levels are good, and we're holding on to hope she can hold on for a few more weeks, long enough to be able to allow her to be born without exposing her brother to horrible risks.

In the meantime, I hope you're doing okay. Are you getting monitored a lot? Have your doctors talked about an early delivery, or are they more worried about a pre-e risk? I'm on low dose aspirin too (I have been since before I got pregnant). My doctor just said there's nothing to do now except wait. It's terrifying, isn't it?
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Re: Raised Uterine Arteries Pulsatility Index & Resistive In

Postby Miss406 » Sun Jun 19, 2016 2:28 pm

inthemetro wrote:Hi Miss. I'm in a similar boat. I'm pregnant with twins. My little boy is healthy (and is in fact big for dates), but my little girl has what I think is the more severe stage of what you're talking about. The doppler of her placenta at just over 24 weeks determined that her EDF flow is absent--which basically means the resistance is stronger than just being raised, and her placenta is really not functioning correctly. She's also very small (she's IUGR, and is at the very bottom of the growth charts). As terrifying as it is, at least she's still growing and her fluid levels are good, and we're holding on to hope she can hold on for a few more weeks, long enough to be able to allow her to be born without exposing her brother to horrible risks.

In the meantime, I hope you're doing okay. Are you getting monitored a lot? Have your doctors talked about an early delivery, or are they more worried about a pre-e risk? I'm on low dose aspirin too (I have been since before I got pregnant). My doctor just said there's nothing to do now except wait. It's terrifying, isn't it?


Good grief, poor you. This is a new thing in the UK and I don't know if I've had it in previous pregnancies to be honest. I had twins in 2010, congratulations on your beautiful twins. I have fraternal twin daughters.

All I really know is on the charts of the blood flow it's off the scales on the paper.

Example [-----O-----] ---------------- *
The O represents the normal range.

As for weight and growth, not too far behind. Stomach measuring just over mid-way, head measuring smaller but long legs like his sperm donor. Despite this condition they estimated his weight a few days ahead of where he actually is. It's a good job I purely believe those words 'estimated'. No ultrasound is 100% guaranteed.

The only monitoring they are doing on me is a repeat ultrasound at 28 weeks (I'm 25 weeks today). I had started a 75mg dose of aspirin whilst TTC"ing, however on the advice of my Fertility Specialist I stopped until 12 weeks pregnant. She said there is evidence of aspirin hindering implantation - and at that point we'd been trying something like 16 months so I stopped it.

They have not mentioned an early delivery and it will not be possible unless absolutely necessary. This is my last baby and I prefer my last baby to be a vaginal delivery. Depending on what the 28 week ultrasound says, the chances are I'm going to have an unassisted delivery, when the baby is ready to be born. Since the growth scans are not massively out, I am not massively concerned.
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Re: Raised Uterine Arteries Pulsatility Index & Resistive In

Postby inthemetro » Mon Jun 20, 2016 12:30 am

That's great your little one is doing so well. The fact that baby's growth is not too far behind is really good. I'm sure at your 28 week appointment they'll watch to make sure he doesn't drop percentiles too fast and that his blood flow hasn't deteriorated. My little girl is more severe. She's teensy (she's at the very bottom of the growth chart), but so far she's still growing and keeping her curve, which is important, and her blood flow hasn't gotten any worse since 24w. I'm going to be admitted on Friday (when I'm 28w) for constant monitoring, so as long as baby girl holds steady they'll keep monitoring the babies as long as possible. As soon as her placenta starts to fail, I'll have an emergency c-section. It's hard to know a timeline, but probably not more than a few weeks given everything.

One thing; I'm also in the UK, and while I hope you don't need an early delivery (and no reason you should if your baby's blood flow doesn't get any worse), you should expect a c-section. A raised uterine arteries index means your baby is fragile and could be endangered by contractions, even if he does go to full term (and I hope he does!). Our doctor said that standard care for these cases is to do a c-section because it's much safer for the baby. I have not been emotionally invested in a vaginal birth (I've never had one--these guys are my first birth), but I wanted to give you a head's up not to expect one.

And thanks for the twin solidarity. That's great you have a set yourself. It was a big surprise for us, but we couldn't be more excited, and while we're super nervous (she's got to make 28 weeks; hopefully prematurity doesn't hurt him too much) we're unbelievably excited.
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Re: Raised Uterine Arteries Pulsatility Index & Resistive In

Postby Miss406 » Thu Jun 23, 2016 12:26 pm

Sorry to hear you'll be admitted for continual monitoring. I hope you take lots of books and thinks to keep you occupied.

They have only just started testing for this condition in the UK, My other babies were fine throughout the pregnancy, labours and births. I don't understand what research and statics they're giving out advice over a caesarean section for. I'd be interested to know based upon what facts, statistics and research they're basing major abdominal surgery as 'safer'.

Whilst my first baby was small for his dates, I've also had 5 other children that were far from being small. As I say, I'm not overly concerned.

I have everything crossed for you and your beautiful twins.
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Re: Raised Uterine Arteries Pulsatility Index & Resistive In

Postby inthemetro » Fri Jun 24, 2016 8:55 am

Good luck, Miss, and I hope you and the baby have as easy a pregnancy as possible. You should definitely ask all your questions at your appointment--I've found at least where I am the doctors have been terrific at explaining everything and helping my husband and I understand the risks we face as well as the stakes of all the choices being made. As for some babies being large and others being small: I think there's a real element of chance there, and you shouldn't second guess yourself. My other twin is actually really large for dates (he's clocked in consistently in the 95th percentile), which shows how some babies just have placental problems, there's nothing we could have done to have prevented it.

As for a c-section: generally if babies need to be born very preterm (like mine) they have to have a section (the surgery is major for mom, but way easier than tolerating contractions for baby), but I hope you get the birth you want! In any case, though, what I tell myself is the most important thing is that the babies are okay, and as for the surgery, the whole thing'll be over fast and I'm sure I'll recover quickly.

Thanks for the fingers crossed, and same to you! Good luck managing everything and taking care of all your big kids, and I hope your appointment goes well.
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Re: Raised Uterine Arteries Pulsatility Index & Resistive In

Postby Miss406 » Fri Jun 24, 2016 1:17 pm

Thank you, best of luck to you as well.

Roll on September / October when we have our babies in our arms.
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Re: Raised Uterine Arteries Pulsatility Index & Resistive In

Postby Miss406 » Sun Jul 24, 2016 12:24 pm

Just an update.

At the 28 week scan I was given the all clear. It is common to get a false +, but you can not get a false -.

There is absolutely nothing wrong with the dopplers. At all.
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