Q: My wife is 16 months pregnant. This is her second pregnancy after 4 years. During a growth scan, it was revealed that her left uterine artery pl -1; it has an early diastolic notch. Umbilical artery flow is normal pl -1.3, right uterine artery pl -0.6; there is no evidence of early diastolic notch in the right uterine artery. Is this a cause for concern? What causes it? How can we avoid this? How will this affect the baby? Is there any medicine to cure it? The baby's growth is normal.

A:At 16 weeks of pregnancy it is perfectly normal for one or both main uterine arteries to show an early diastolic notch. As pregnancy advances this notch disappears. It reflects the relationship between the growing placenta and the muscles and blood vessels in the uterus. The notch disappears by 22 weeks of pregnancy. Persistence of the notch after 22 weeks is associated with pregnancy-induced hypertension, low birth weight, and higher rates of operative delivery and longer duration of nursery care. The notch can be very satisfactorily treated with medication. There is no cause for alarm at this stage.