P08.21: Screening for pre‐eclampsia by second trimester uterine artery Doppler evaluation

Abstract

Second trimester uterine artery/UA/Doppler screening for pre-eclampsia (PE) has been well established. We present the results from a prospective study of high-risk singleton pregnancies undergoing such a screening between 2002 and 2009 in Bulgaria. Bilateral UA Doppler analysis was performed between 18 and 24 w.g. Mean RI and PI indices were calculated. Presence of notching was also recorded. Logistic regression analysis was performed. 169 pregnant women were enrolled in the study. 37 patients developed PE and 11 of those delivered < 34 w.g. There was no difference in the mean maternal age, parity and gestational age between the groups at inclusion. The 90th centile RI had a better sensitivity for PE than the 95th centile with a FPR < 10%. The high mean PI raised the relative risk /RR/ for development of PE 4.8 times (71% sensitivity and 5.3% FPR, P = 0.034). The mean RI > 90th centile was associated with a significant increase of the RR for development of PE and early PE—3.8 and 8.5 times, respectively (95% CI 1.34–10.9). The best predictor for development of PE and PE < 34 w.g. was the combination of RI > 90th centile and the presence of bilateral notching—65 times increased RR for development of early PE, with 81% sensitivity and 1.2% FPR (95% CI 6–699). UA Doppler analysis is a non-invasive screening modality for assessment of patients at risk for development of PE, in particular those requiring delivery < 34 w.g. RI and PI evaluation, combined with presence of notching, is the best predictor in identifying high-risk pregnancies.