Trimester Uterine Artery Doppler Research Articles

OP09.07: Second trimester uterine artery Doppler to predict placenta‐associated complications in women with systemic lupus eritematosus (SLE)

OP09.07: Second trimester uterine artery Doppler to predict placenta‐associated complications in women with systemic lupus eritematosus (SLE)

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

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.

OP10.08: Postnatal functional echocardiography (fECHO) in neonates with abnormal fetal umbilical artery Doppler (UAD)

which in turn may cause less of a rise in heart rate (HR). Uterine artery Doppler (UtAD) provides a method of assessing risk for the development of pre-eclampsia. We examined the relationship between second trimester UtAD pulsatility index (PI), HR and birth weight. Methods: 99 women were recruited from the high-risk obstetric ultrasound clinic in the second trimester; median (± IQR) age and gestation were 33 (29–37) years and 23+6 (23+3–24+4) weeks respectively. Mean values of UtAD PI were recorded. Cardiovascular measurements including HR were performed at a later date (26+5 (25+6–28+0) weeks gestation). Gender specific z-scores were calculated from the unit’s previous 5 years’ births. Results: We found a significant positive correlation between HR and birth weight z-score, r = 0.22 (P = 0.03, 95% CI: 0.02–0.40). This correlation remained when 4 patients taking β-blockers were excluded, r = 0.21 (P = 0.04, 95% CI: 0.01–0.40). An inverse association was found between UtAD PI and HR r = −0.43 (P = 0.0001, 95% CI: 0.01–0.40). Conclusions: The novel finding is that lower second trimester HR is associated with lower birth weight; we hypothesize that this reflects inadequate cardiovascular adaptation to pregnancy. We confirm the previously described effect of HR on UtAD PI. However, it is not possible to determine whether this was a direct effect of HR on UtAD PI, or whether women with abnormal placentation are more likely to have a slower HR. This has obvious implications for predictive models using both UtAD and HR.

Prediction of Pre-Eclampsia by a Combination of Maternal History, Uterine Artery Doppler, and Mean Arterial Pressure (A Prospective Study of 200 Cases)

To determine the clinical value of uterine artery Doppler Pulsatility index (PI) at 22-24+6weeks scan and importance of maternal history and mean arterial pressure (MAP) in the prediction of pre-eclampsia. This was a prospective screening study of 200 women with singleton pregnancy. Maternal history and blood pressure were recorded, and MAP was calculated. Transabdominal Doppler ultrasound of uterine artery was performed. Mean PI was calculated, and the presence or the absence of bilateral early diastolic notch was noted. Women were then followed up through pregnancy and delivery for the development of pre-eclampsia, gestational hypertension, and SGA. The mean±SD PI value for subjects who had an adverse pregnancy outcome was significantly higher (0.84±0.28) than mean±SD PI value for subjects who had normal pregnancy outcome (0.71±0.16) with P value <0.000. Second trimester uterine artery Doppler is a useful screening method for identification of high risk pregnancy in women who can be kept under close surveillance for better maternal and neonatal outcome. This test works better when combined with previous history of pre-eclampsia and MAP.

389: Placental biometry and intraplacental villous artery Doppler as predictors of placentally-mediated pregnancy complications

389: Placental biometry and intraplacental villous artery Doppler as predictors of placentally-mediated pregnancy complications

390: The added value of second trimester uterine artery Doppler in the identification of nulliparous women at increased risk for preeclampsia: an individual patient data metaanalysis

390: The added value of second trimester uterine artery Doppler in the identification of nulliparous women at increased risk for preeclampsia: an individual patient data metaanalysis

OP09.06: First trimester uterine artery Doppler and placental 3D power Doppler vascular flow in the prediction of Preeclampsia

OP09.06: First trimester uterine artery Doppler and placental 3D power Doppler vascular flow in the prediction of Preeclampsia

OP09.03: First and second trimester uterine artery Doppler study in high‐risk women for preeclampsia

OP09.03: First and second trimester uterine artery Doppler study in high‐risk women for preeclampsia

OP09.01: First trimester uterine artery Doppler velocimetry and arterial tonometry

OP09.01: First trimester uterine artery Doppler velocimetry and arterial tonometry

OP27.07: The comparison of two technical approaches for first trimester uterine artery Doppler velocimetry and correlation with mid‐trimester Doppler

OP27.07: The comparison of two technical approaches for first trimester uterine artery Doppler velocimetry and correlation with mid‐trimester Doppler

Uterine Artery Doppler and Prediction of Preeclampsia

Identifying patients at risk for preeclampsia would allow an increase in perinatal surveillance and possibly decrease the inherent maternal and fetal morbidity and mortality associated with severe preeclampsia and eclampsia. First and second trimester uterine artery Doppler velocimetry is a sensitive screening tool for the detection of preeclampsia and intrauterine growth retardation (IUGR) requiring delivery before 34 weeks. The performance of uterine artery Doppler velocimetry as a screening test depends on the prevalence of the adverse outcome in the studied population and whether the adverse outcomes are assessed individually or collectively as a group. Future research in this area should focus on identification of additional markers that may be incorporated into a prediction model for early identification of patients at risk for adverse outcomes.

OP34.08: First trimester uterine artery Doppler, placental volume and ductus venosus blood flow as predictors of second trimester fetal growth

OP34.08: First trimester uterine artery Doppler, placental volume and ductus venosus blood flow as predictors of second trimester fetal growth

OP37.04: Sensitivity of the higher, lower and mean second trimester uterine artery Doppler resistance index in screening for pre‐eclampsia

OP37.04: Sensitivity of the higher, lower and mean second trimester uterine artery Doppler resistance index in screening for pre‐eclampsia

RISK FACTORS AND PREDICTION OF PREECLAMPSIA

Inadequate trophoblast invasion of the spiral arteries in early pregnancy, an increased inflammatory response and changes in the immune answer to paternal antigens are considered aetiological factors in preeclampsia.Searching for factors related to these angiogenic, anti-angiogenic, immunologic and inflammatory mechanisms may provide methods to determine which patient will develop preeclampsia predating the onset of the clinical manifestations of the disease.Screening for preeclampsia in the first trimester has had limited success. Currently, maternal characteristics, clinical history, maternal serum biochemistry and uterine artery Doppler sonography before 14 weeks are being investigated. Preeclampsia in a previous pregnancy is still the strongest predictor. In the second trimester, uterine artery Doppler has a detection rate around 60% but also a high false positive rate of 25%. First trimester uterine artery Doppler studies have high sensitivity but poor specificity with a high false positive rate. Combination of first trimester uterine artery Doppler with patient characteristics and maternal serum biochemistry, specifically placental protein 13 holds promise but further evaluation is needed.Maternal serum markers including inhibin A, activin A, soluble FMS-like tyrosine kinase 1, endoglin, pregnancy associated plasma protein A and others, when used alone have proved poor predictors of preeclampsia. Most studies have been performed by a limited group of researchers in a population with a high risk and no validation studies of any method in other populations are available. Results are difficult to compare due to differences in methodology, and differences in the end point studied. There are still no good methods of preventing preeclampsia once a high risk has been determined.

Value of Third Trimester Uterine Artery Doppler in High-risk Pregnancies for Prediction of Adverse Perinatal Outcome

ABSTRACT Objective To determine the usefulness of uterine artery Doppler in evaluation of third trimester high-risk pregnancies in prediction of adverse perinatal outcome. Methods In this prospective study uterine artery Doppler parameters such as PI and early diastolic notch were recorded in a group of 60 high-risk pregnancies mainly consisting of pre-eclampsia and small for gestational age. Uterine artery score (UAS) was calculated from the Doppler parameters and a score ≥ 2 was considered abnormal. Perinatal outcome was then correlated to this score and compared with umbilical artery Doppler. Results Abnormal UAS was noted in 72% of the study group while umbilical artery Doppler was abnormal in only 35%. All the five perinatal deaths and high-rate of perinatal morbidity was observed when both uterine and umbilical artery Dopplers were abnormal. Perinatal morbidity parameters such as birth weight &lt; 2 kg, gestational age &lt; 34 weeks and NICU admission was significantly high in 23 women who had abnormal UAS with normal umbilical artery Doppler. In pregnancies beyond 34 weeks abnormal uterine artery Doppler was a better predictor of adverse outcome than umbilical artery Doppler. Conclusion Abnormal uterine artery Doppler is a reliable predictor of adverse perinatal outcome in high-risk pregnancies with preeclampsia and fetal growth restriction. Normal uterine artery Doppler in third trimester is reassuring. Thus inclusion of uterine artery Doppler along with umbilical artery Doppler in high-risk pregnancy in third trimester will improve fetal surveillance.

716: Second trimester uterine artery Doppler in women with abnormal quad screen analytes

There are no proven interventions and no data available to help formulate recommendations regarding antenatal surveillance in women with abnormal maternal serum markers. The object of this study was to determine if second trimester uterine artery Doppler velocimetry is associated with preeclampsia (Pet) and birthweight ≤5th percentile (bwt ≤5) in women with unexplained abnormal maternal serum quad screen analytes.

283: Screening for preeclampsia using first and second trimester uterine artery Doppler and maternal characteristics in nulliparous women

283: Screening for preeclampsia using first and second trimester uterine artery Doppler and maternal characteristics in nulliparous women

P79 Value of third trimester uterine artery Doppler for prediction of adverse perinatal outcome in high risk pregnancies

International Journal of Gynecology & ObstetricsVolume 107, Issue S2 p. S433-S434 Poster presentations P79 Value of third trimester uterine artery Doppler for prediction of adverse perinatal outcome in high risk pregnancies L. Rai, L. RaiSearch for more papers by this authorL. Shivananda, L. ShivanandaSearch for more papers by this author L. Rai, L. RaiSearch for more papers by this authorL. Shivananda, L. ShivanandaSearch for more papers by this author First published: 20 November 2009 https://doi.org/10.1016/S0020-7292(09)61570-8AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume107, IssueS2Abstracts of XIX FIGO World Congress of Gynecology and ObstetricsOctober 2009Pages S433-S434 RelatedInformation

P204 Mid trimester uterine artery Doppler screening as a predictor of adverse pregnancy outcome in high risk pregnant women

P204 Mid trimester uterine artery Doppler screening as a predictor of adverse pregnancy outcome in high risk pregnant women

OP14.03: Longitudinal study of maternal insulin-like growth factor-I and uterine artery Doppler

Objective: To evaluate the performance of screening for preeclampsia (PET) in women who had both first and second trimester uterine artery (UtA) Doppler. Methods: This longitudinal study involved 3090 asymptomatic pregnant women who had UtA pulsatility index (PI) routinely at 11–14 and 20–25 weeks gestation. Demographic characteristics was also recorded contemporary. Multiple regression analysis was used to evaluate which of the maternal variables and Doppler findings were significant predictors of early-onset PET. Receiveroperating characteristics curves were used to evaluate the value as screening of different combined predictive models. Results: There were 93 (3.0%) women who later developed PET, including 30 women who delivered before 34 weeks gestation (early PET). Early and late PET differed substantially in their UtA PI findings during the first and second trimester of pregnancy. Multiple regression analysis showed that increased body mass index, previous PET, UtA PI at 11–14 and 20–25 weeks gestation, and the change in UtA resistance between the first and second trimester were significantly associated with the appearance of early PET. The detection rate of early PET for a 10% false positive rate in screening by maternal characteristics and first trimester UtA PI only and by a combination with a ratio between both UtA Dopplers was 50% and 82%, respectively. However, second trimester UtA PI alone was able to detect about 90% of women who subsequently developed early cases. Conclusion: This study has confirmed that the severe the PET the lower the magnitude of change in uterine artery dilatation between the first and second trimester of pregnancy. In addition, although the best methods to predict early PET is still the second trimester uterine artery Doppler, a combination between maternal findings, UtA Doppler at 11–14 weeks gestation and the ratio of changes between both trimesters should be also a good screening test for early PET. Supported by Fondecyt No 1090245