EP05.03: Reproducibility and repeatability of uterine artery Doppler pulsatility index and bilateral diastolic notch between 11–14 weeks of gestation

Abstract

To assess intraobserver repeatability and interobserver reproducibility of uterine artery (UtA) Doppler Pulsatility Index (PI) and presence/absence of bilateral diastolic notch between 11–14 weeks of gestation Singleton pregnancies attending for first trimester anomaly scan/Down's risk assessment at São Paulo Federal University were recruited. Doppler analysis of both UtA was carried out abdominally in 50 consecutive pregnant twice by the first examiner (GL) and then once by a second examiner (PN). Both examiners are experienced on Fetal Doppler Ultrasound with Certificate of Competence issued by FMF. Left and right UtA PI were assessed and mean PI was calculated. In addition, both examiners classified qualitatively the blood flow with regard to the presence or absence of a bilateral early diastolic notch. Mean BMI, mean CRL and proportion of nulliparous in the study population was 25.4, 65.2 mm (12w6d) and 34%, respectively. Mean UtA PI and standard deviation was 1.72 (0.44) and 1.67 (0.44) for the first and second measurements of the first examiner (GL) respectively. Mean UtA PI and standard deviation was 1.72 (0.44) and 1.65 (0.41) for the first measurement of the first examiner and measurement of the second examiner (GL X PN) respectively. In both comparison (GL X GL and GL X PN), differences between measurements were not statistically significant (p value = 0.051 for both).Bilateral early diastolic notch had high level of agreement in both intra and interobserver analysis, as shown by Kappa coefficient of 0.854 and 0722 respectively First trimester UtA Doppler quantitative and qualitative assessment has high reproducibility and repeatability, when performed by experienced examiners.