Uterine Artery Doppler In Prediction Research Articles

Uterine Artery Doppler as Predictive Measure for Fetal Growth Restriction in Chronic Hypertensive Patients

Background: Fetal growth restriction (FGR) is when the fetal weight is less than tenth centile for the given gestational age. Chronic hypertension is one of the risk factors of FGR. Growth restricted fetuses are at risk of intrauterine death and many comorbidities later in life. Detection of those fetuses at risk of developing FGR can help in timely intervention and better outcome.Objective: To evaluate uterine artery Doppler for prediction of FGR in patients with chronic hypertension.Methods: One hundred and sixty four women having chronic hypertension at 24 weeks of gestation were included in the study. Women with multiple pregnancy and comorbidities other than hypertension were excluded. Doppler USG of uterine arteries was done at 24 weeks of gestation by radiologist and absence or presence of diastolic uterine artery notch was observed. Patients were divided into 2 groups A and B depending upon the presence or absence of notch respectively. These women were followed till they delivered and by taking birth weight as an outcome measure, frequency of fetal growth restriction (FGR) was found in both groups by the researchers themselves.Results: The mean age of women in group A was 26.76± 3.89 and in group B was 26.21 ± 3.57 years. Major portion of women was multipara 58% (96 women). Forty (24.39%) patients developed fetal growth restriction while 124 patients (75.61%) fetuses were of normal weight. Among the patients who had growth retarded foetuses 35.37% patients were in group A and 13.41% were in group B with p-value of 0.001.Conclusion: Uterine artery doppler diastolic notch at 24 weeks of gestation has significant association with development of FGR in patients with chronic hypertension.

Role of PAPP-A (Pregnancy Associated Plasma Protein-A), PlGF (Placental Growth Factor) and uterine artery doppler in prediction of preeclampsia

Role of PAPP-A (Pregnancy Associated Plasma Protein-A), PlGF (Placental Growth Factor) and uterine artery doppler in prediction of preeclampsia

Role of uterine artery Doppler in prediction of preeclampsia and associated adverse outcomes between 12-20 weeks in low risk pregnancies

Role of uterine artery Doppler in prediction of preeclampsia and associated adverse outcomes between 12-20 weeks in low risk pregnancies

Third-trimester uterine artery Doppler for prediction of adverse outcome in late small-and adequate for-gestational-age fetuses.

Fetal growth restriction includes all those fetuses that do not reach their own growth potential due to placental insufficiency and therefore at higher risk of adverse perinatal outcomes. Identification and follow-up of these fetuses is essential to decrease this additional risk. Although estimated fetal weight under the 3rd centile and pathological cerebroplacental ratio are the most accepted predictive criteria, some evidence suggests that abnormal uterine artery Doppler may be a useful prognostic parameter in late-onset growth restriction fetuses at the moment of diagnosis. However, its prediction capacity as a standalone parameter is limited. In that context, integrated models of biometric and hemodynamic ultrasound parameters including uterine Doppler have been proposed as an effective approach to stratify the risk and improve perinatal outcomes. Moreover, an association of abnormal uterine artery Doppler and histological findings of placental underperfusion due to vascular obstruction has been described. Finally, it has also been suggested that the evaluation of uterine artery Doppler at third trimester in appropriate-for-gestational-age fetuses could identify cases of subclinical placental insufficiency, but further evidence is needed to define such predictive strategies.

PREDICTION OF PREECLAMPSIA BY UTERINE ARTERY DOPPLER

Objective: To evaluate the role of mean pulsatility index by rst trimester uterine artery doppler in prediction of preeclampsia. A prospective observational study was conducted in a tertiary c Methodology: are center. Of 200 women screened, 136 women met eligible criteria and 130 consented for participation in the study. In addition to nuchal translucency and crown-rump length, mean uterine artery pulsatility index (PI) was measured at 11–13+6 weeks, and women were followed up till delivery to observe the development of gestational hypertension, preeclampsia and fetal growth restriction (FGR). Categorical variables were analyzed using ROC curve, and P≤0.05 (5%) was used to calculate signicance. Among 130 women followed t Results: ill delivery, 9 (6.92%) had mean PI >95% and 121 (93.08%) had normal Doppler. A signicantly higher number of women with PI ≥95% had preeclampsia (55.55%) (p < 0.001), and the sensitivity of PI in prediction of preeclampsia was 55.55% with specicity of 98.80%. No association was found between PI and FGR (p = 0.228). Conclusion: This study showed a positive association with the development of preeclampsia . The predictive accuracy of rst trimester uterine artery Doppler using PI with cutoff of >95% has low sensitivity in prediction of preeclampsia (55.55%) but it has high specicity(98.80%) for prediction of PE(Preeclampsia).

Third trimester uterine artery Doppler for prediction of adverse perinatal outcomes.

Abnormal uterine artery Doppler (UtAD) studies early in gestation have been associated with adverse pregnancy outcomes. However, their association with complications in the third trimester is weak. We aim to review the prediction ability for perinatal complications of these indices in the third trimester. Abnormal UtAD waveforms in the third trimester are associated with preeclampsia, small-for-gestational age infants (SGA), preterm birth, perinatal death, and other perinatal complications, such as cesarean section for fetal distress, 5 min low Apgar score, low umbilical artery pH, and neonatal admission to the ICU, particularly in SGA infants. UtAD prediction performance is improved by the addition of maternal characteristics as well as biochemical markers to prediction models and is more precise if the evaluation is made closer to delivery or diagnosis. This review shows that the prediction accuracy of UtAD for adverse pregnancy outcomes during the third trimester is moderate at best. UtAD have limited additive value to prediction models that include PlGF and sFlt-1. Serial assessments rather than a single third trimester evaluation may enhance the prediction performance of the UtAD combined models.

Placental Size and Uterine Artery Doppler for Prediction of Adverse Pregnancy Outcomes in Women with Low Pregnancy-Associated Plasma Protein-A

Background: Patients with a low level of pregnancy-associated plasma protein-A (PAPP-A) experience more placental disorders in the second trimester. Objectives: We aimed to assess UtA-Doppler and placental size to predict adverse pregnancy outcomes in a woman with placental insufficiency and low PAPP-A. Methods: Following a cross-sectional design, 83 singleton pregnant women with normal chromosomes and PAPP-A ≤ 0.5 were examined at 11 - 13 + 6 weeks of gestation. All participants with PAPP-A ≤ 0.5 were tested in the Nilo laboratory of Tehran from 2018 to 2019. The placental size and Doppler uterine artery were assessed at 18 - 20 weeks. Three cases were excluded due to abortion and aneuploidy. All participants were assigned to placenta lengths of < 10 cm and > 10 cm. All comparisons between two groups were assayed by the independent t-test, Mann-Whitney U test, χ2-test or Fisher exact test, and Logistic regression model. Results: Of 80 women, 48 (60%) had placenta length of < 10 cm and 32(40%) had placenta length of > 10 cm. Fourteen (17.5%) were preterm (< 32 weeks), and 36(45%) were IUGR. According to the logistic regression model, in participants with a placenta length of < 10 cm, the risk of IUGR was higher by 9-time than those with placenta length of > 10 cm (OR = 9, CI95% = 3.20 - 25.29). Also, the risk of preterm labor was 3.47 fold higher in the group with placenta length of < 10 cm, OR: 3.47;( CI95% = 1.27 - 9.44). Sensitivity of placenta length of < 10 cm for predicting IUGR was 75% (CI95% = 56.60 - 88.54). Conclusions: Placental length measurement in the second trimester can help predict adverse pregnancy outcomes in pregnant women with low PAPP-A. Placenta evaluation can assist in planning future pregnancy care to detect the pathology of fetal growth restriction.

Cervical length Measurements and Uterine Artery Doppler in Prediction of Preterm Labour of High-Risk Women

Cervical length Measurements and Uterine Artery Doppler in Prediction of Preterm Labour of High-Risk Women

Role of Uterine Artery Doppler in Prediction of Preeclampsia: A Prospective Analytical Study

Introduction: Preeclampsia is pregnancy specific hypertensive disorder of pregnancy which is associated with both high maternal and perinatal morbidity and mortality. Timely prediction and management in time, are the two key factors for prevention of these morbidities and mortalities. The aim of present study was to evaluate role of uterine artery doppler in prediction of preeclampsia in second and third trimester of pregnancy in Indian setting. Materials and Methods: This was a prospective analytical study done at department of Obstetrics and Gynaecology, King George Medical university, Lucknow over a period of one year. After ethical approval (Institutional Ethics Committee, KGMU, Lucknow, Ref. Code: 92nd ECM II B- thesis P/29.) and informed consent from every patient, recruitment was done. Group I had 120 normotensive patients and Group 2 had 100 preeclampsia patients at time of enrollment. Bilateral uterine artery doppler was done for every patient and patient were further followed for maternal and perinatal outcome. Results: Total 220 patients were studied. In Group 1, 15 patients developed preeclampsia. Both groups were comparable for maternal age and parity. However, BMI was found to be significantly higher in the patients of Preeclampsia group. Uterine artery doppler, showed statistically significant difference and it was high in preeclampsia group. It had high negative predictive value. Gestation of termination was significantly lower in preeclampsia group. Fetal birth weight was significantly lower in preeclampsia group. Conclusion: Uterine artery doppler is a non-invasive test with high negative predictive value which should be utilized for prediction of preeclampsia for all pregnant patients.

Predictive Value of both Serum Placental protein 13 Level and Uterine Artery Doppler for Prediction of Pre-Eclampsia

Background: Preeclampsia [PE] is one of the commonest medical emergencies. It had high morbidity for the mother and her infant. Early diagnosis could reduce such morbidity. Aim of the work: To evaluate the role of maternal serum placental protein [PP13] levels and uterine artery Doppler in early prediction and prognosis of preeclampsia.Patients and Methods: The study included 60 pregnant women in their first and early second trimester with high risk for preeclampsia. Patients were divided into three groups: control, mild and sever preeclampsia. All were subjected to proper history taking, clinical and obstetrical examination, laboratory investigations and ultrasound examination.Results: Cesarean delivery was significantly increased in preeclampsia compared to controls [55% of mild and 20% of severe disease compared to 15% of controls]. Both uterine artery resistance index [RI] and pulsatility index [PI] were significantly increased in PE when compared to control and in severe when compared to mild PE groups. Finally, PP13 was significantly decreased in patients with severe PE [171.7±35.9] when compared to mild PE [213.1±41.8] or control group [254.8±51.1]. In addition, there was significant decrease in cases with mild PE when compared to control group. Finally, there was inverse [negative], moderate and statistically significant correlation between PP-13 from one side and each of systolic BP, diastolic BP, uterine artery RI and PI. In addition, both RI and PI were proportionally correlated with PI and RI.Conclusion: The present study showed that PP13 combined with PI or RI can predict PE with a good sensitivity and specificity.

Third-trimester uterine artery Doppler for prediction of adverse outcome in late small-for-gestational-age fetuses: systematic review and meta-analysis.

To investigate the predictive ability for adverse perinatal outcome of abnormal third-trimester uterine artery Doppler in late small-for-gestational-age (SGA) fetuses. A systematic search was performed to identify relevant observational studies and randomized controlled trials evaluating the performance of abnormal third-trimester uterine artery Doppler for the prediction of adverse perinatal outcome in suspected SGA fetuses and SGA neonates. Abnormal uterine artery Doppler was defined as uterine artery pulsatility index > 95th percentile or ≥ 2 SD above the mean, or bilateral uterine artery notching. Hierarchical summary receiver-operating-characteristics (ROC) curves were constructed using random-effects modeling. Bayesian analysis was used to calculate the posterior probability of adverse perinatal outcome following an abnormal or normal uterine artery Doppler assessment. Seventeen observational studies (including 7552 fetuses either diagnosed with suspected SGA (n = 3461) or later diagnosed as a SGA neonate (n = 4091)) met the inclusion criteria; no randomized-controlled trials met the inclusion criteria. Summary ROC curves showed that, among suspected SGA fetuses, the best predictive accuracy of abnormal third-trimester uterine artery Doppler was for perinatal mortality and the worst was for composite adverse perinatal outcome, with areas under the summary ROC curves of 0.90 and 0.66, respectively. The corresponding positive and negative likelihood ratios were 16.5 and 0.6 for perinatal mortality and 2.82 and 0.65 for composite adverse perinatal outcome, respectively. Following an abnormal vs normal uterine artery Doppler assessment, the posterior risks for composite adverse perinatal outcome, admission to the neonatal intensive care unit, Cesarean section for intrapartum fetal compromise, 5-min Apgar score < 7, neonatal acidosis and perinatal death were: 52.3% vs 20.2%, 48.6% vs 18.7%, 23.1% vs 15.2%, 3.59% vs 1.32%, 9.15% vs 5.12% and 31.4% vs 1.64%, respectively. Abnormal uterine artery Doppler in the third trimester appears to be moderately useful in predicting perinatal death in pregnancies with suspected SGA. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Role of First and Second Trimester Uterine Artery Doppler in Prediction of Pre-Eclampsia

Role of First and Second Trimester Uterine Artery Doppler in Prediction of Pre-Eclampsia

Role Of Uterine Artery Doppler For Prediction Of Fetal Outcome In Preeclamptic Patients

Objective: The aim of this prospective observational study is to assess the accuracy of Doppler indices of uterine artery during the third trimester in predicting poor fetal outcome in women with preeclampsia. Methods: Study design: Cohort observational study among women with preeclampsia. Study setting: One hundred cases who were at 32 to 40 weeks of gestation with preeclampsia(from March 2017 to March 2018) attended antenatal clinic and emergency room at obstetrics and gynecology department, faculty of medicine, Sohag University Hospital. Ultrasound was performed at the fetal care unit at Sohag University Hospital. Results: This observational cross-sectional study was designed to assess Doppler indices of uterine artery as predictor of neonatal outcomes among women with preeclampsia.A total of 100 pregnant women with preeclampsia were recruited in the study Conclusion: We recommend adding mean uterine artery Doppler indices to routine antepartum fetal surveillance from 32 weeks gestation for women with preeclampsia as there is a strong correlation between it and poor neonatal outcomes.

Uterine Artery Doppler for Prediction of Amenorrhea in Women Desiring to use the Lactational menorrhea Method for Contraception

Uterine Artery Doppler for Prediction of Amenorrhea in Women Desiring to use the Lactational menorrhea Method for Contraception

Serum biomarkers combined with uterine artery Doppler in prediction of preeclampsia

Preeclampsia is a multi-systemic disease which affects 4-5% of pregnancies, being one of the main causes often leading to death for both the mother and the baby, the death rate going up to 50,000-60,000 cases on an annual basis, which occurs in countries where the income is low or average. Although preeclampsia is considered one of the medical disorders that are still uncertain, recent research raises the question of the endothelial dysfunction, thus the imbalance between pro-angiogenic and anti-angiogenic factors is taken into consideration both as a means to diagnose and prognosticate it. Furthermore, the biomarkers play a key role regarding the disease, being subject to accurate interpretation. Measurements of the IP of the uterine blood vessels through Doppler interpretation during the second term of the pregnancy might bring further evidence in support of identifying preeclampsia features, which emphasize the role of the biomarkers in predicting the development of the disease.

EP17.16: Angiogenic factors and uterine artery Doppler for prediction of pre‐eclampsia in high‐risk population

EP17.16: Angiogenic factors and uterine artery Doppler for prediction of pre‐eclampsia in high‐risk population

Serum biomarkers combined with uterine artery Doppler in prediction of preeclampsia.

First-trimester screening may be a major advantage over a second-trimester approach since it opens prospects for early and more efficient interventions. The aim of the current study was to evaluate whether the measurement of maternal serum inhibin A, activin A and placental growth factor (PlGF) at three to four months gestation with the second-trimester uterine artery pulsatility index (PI) are useful in predicting preeclampsia in a group of nulliparous women. All the patients also underwent uterine artery Doppler examination to measure the PI at 22–24 weeks gestation. Inhibin A, activin A and PlGF were measured using an ELISA by an examiner who was blinded to the pregnancy outcome. Thirty-eight cases with preeclampsia and 100 controls were analyzed. Second-trimester uterine artery PI and marker levels were expressed as multiples of the median (MoM). The uterine artery PI was increased in pregnancies with preeclampsia compared with controls. In pregnancies that developed preeclampsia, the uterine artery PI was increased (1.61±0.047 vs. 1.02±0.049, P<0.001), as was the level of inhibin A (1.72±0.023 vs. 1.03±0.063, P<0.001) and the level of activin A (1.68±0.38 vs. 1.06±0.42, P<0.001) compared with the controls. In contrast, the level of PlGF was decreased in pregnancies that developed preeclampsia compared with the controls (0.69±0.23 vs. 1.00±0.26, P<0.001). A combination of activin A, PlGF and uterine artery PI gave an AUC of 0.915 (95% CI, 0.812–0.928; P<0.001) with a sensitivity of 91% at a specificity of 82%. In our study, we demonstrated that both serum inhibin A and activin A levels were increased, while the PlGF level was decreased in the early second-trimester in women who developed preeclampsia.

Combination of serum angiopoietin-2 and uterine artery Doppler for prediction of preeclampsia

The aim of this study was to determine the predictive value of the combination of serum angiopoietin-2 (Ang-2) levels and uterine artery Doppler for the detection of preeclampsia in women at 16-18 weeks of gestation and to identify other pregnancy complications that could be predicted with these combined tests. Maternal serum Ang-2 levels were measured, and uterine artery Doppler was performed in 400 pregnant women. The main outcome was preeclampsia. The predictive values of this combination were calculated. Twenty-five women (6.3%) developed preeclampsia. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of uterine artery Doppler combined with serum Ang-2 levels for the prediction of preeclampsia were 24.0%, 94.4%, 22.2% and 94.9%, respectively. For the prediction of early-onset preeclampsia, the sensitivity, specificity, PPV and NPV were 57.1%, 94.1%, 14.8% and 99.2%, respectively. Patients with abnormal uterine artery Doppler and abnormal serum Ang-2 levels (above 19.5 ng ml(-1)) were at higher risk for preterm delivery (relative risk=2.7, 95% confidence interval 1.2-5.8). Our findings revealed that the combination of uterine artery Doppler and serum Ang-2 levels at 16-18 weeks of gestation can be used to predict early-onset preeclampsia but not overall preeclampsia. Thus, this combination may be a useful early second trimester screening test for the prediction of early-onset preeclampsia.

The accuracy of transvaginal ultrasound and uterine artery Doppler in the prediction of adenomyosis

Abstract Objective To measure the accuracy of the ultrasonographic features in predicting adenomyosis and to determine if there is a role for uterine artery Doppler in adenomyosis prediction. Study design A prospective comparative study. Setting Cairo University hospital. Materials and methods Three hundred and fifty-two women who were scheduled for hysterectomy for various indications underwent preoperative transvaginal ultrasound scan (TVS) and uterine artery Doppler velocimetry in an attempt to diagnose adenomyosis. All the results were then correlated with histopathological results after hysterectomy. Results Forty-eight participants were ultrasonographically diagnosed as having adenomyosis from which 37 patients were histologically confirmed. Both groups were comparable in age, but adenomyosis tend to occur in multiparas. We found that subendometrial linear striations, myometrial cysts’ number and poor endometrial delineation were significantly associated with adenomyosis. Sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of TVS for diagnosing adenomyosis were: 75.68%, 90.79%, 49.12%, 96.95% and 89.20%, respectively. Heterogenous myometrial echotexture was the most common ultrasonographic feature in adenomyotic cases. Neither uterine artery resistance index nor pulsatility index showed significant association with adenomyosis. Conclusion TVS is a potentially valuable tool in predicting adenomyosis especially when subendometrial linear echogenic striations, myometrial cysts, and poor endometrial delineations were found. However, uterine artery Doppler has no diagnostic values.

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