Uterine artery flow notching
The presence of notching after 22 weeks is associated with several other conditions including adverse pregnancy outcomes. These include
- pregnancy induced hypertension (PIH)
- pre eclampsia
- placental abruption
- intra-uterine growth restriction (IUGR)
- increased maternal serum alpha feto protein (MSAFP)
While notching can be either systolic or diastolic, it is typically seen as a trough like notch between the systolic and diastolic phases.
The presence of a notching in late in pregnancy is an indicator of increased uterine vascular resistance and impaired uterine circulation 2. Bilateral notching is more concerning. Unilateral notching of the uterine artery on the ipsilateral side of the placenta, if the placenta is along one lateral wall (right or left) carries the same significance as bilateral notching. The presence of an early diastolic notch can however be a normal finding in a non-pregnant uterus and even in a pregnant gravid uterus at least up to 16 weeks.
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