Impact of Diurnal Variation on Umbilical Artery Doppler Measurements in Pregnancies Complicated by Hypertensive Disorders

Abstract

Objective

The study aims to determine whether the time of day influences these parameters compared to normotensive pregnancies.

Materials and Methods

This prospective, single-center study included 60 pregnant women diagnosed with hypertensive disorders (gestational hypertension, chronic hypertension, or preeclampsia) and 60 normotensive controls, all between 30 and 37 weeks of gestation. Umbilical artery Doppler measurements were performed twice daily, between 08:00–10:00 and 20:00–22:00, by the same experienced operator. Measurements were taken at both the fetal and placental ends of the umbilical artery, recording systolic/diastolic ratios, pulsatility index, and resistance index values.

Results

In Doppler measurements, the morning and evening evaluations revealed that S/D, PI, and RI values near the fetus and placenta were significantly higher in the study group compared to the control group. Notably, in the preeclampsia subgroup, the morning S/D values (3.3±1.1 vs. 2.3±0.5, p<0.001) were found to reach the highest levels. Regarding neonatal outcomes, the study group demonstrated significantly higher rates of cesarean delivery (71.7% vs. 33.3%, p<0.001) and neonatal intensive care unit admission (36.7% vs. 6.7%, p<0.001), while birth weight was significantly lower (2724.9±759.1 g vs. 3241.1±422.7 g, p<0.001).

Conclusion

This study demonstrates that hypertensive disorders during pregnancy have a significant adverse effect on umbilical artery Doppler measurements and neonatal outcomes. These findings underscore the importance of early diagnosis and meticulous monitoring.

Keywords

Hypertensive disorders - umbilical artery - doppler - preeclampsia - diurnal circadian rhythm - perinatal outcomes

Publication History

Received: 10 July 2025

Accepted after revision: 08 January 2026

Article published online:
03 February 2026

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