Doppler investigation of uteroplacental blood flow resistance in the second trimester: a screening study for pre‐eclampsia and intrauterine growth retardation

Abstract

Objective-To assess the screcning propertics of a mid-trimester uteroplacental Doppler scan in a normal unselectcd population. Design-A cross-sectional study measuring an averaged resistance index (AVRI) from four sites (left and right uterine and arcuate arteries) with continuous wave Doppler ultrasound. Setting-Rout ine booking ultrasound, King's College Hospital, London. Subjects-977 women at 16-24 weeks gestation. Mairi outcome measures-Intrauterine death, birthweight, pregnancy-induced hypertension (PIH), antepartum haemorrhage. Results-There was a 96.5% follow-up. Pregnancies with high AVRI values had a higher prcvalence of proteinuric hypertension, placental abruption, small-forgestational-age babies, and fetal loss. When AVRI was >95th centile, the ovcrall risk of pregnancy complications was 67%, and the risk of a severe complication was 25%. However, the sensitivity of the test for these complications was only 13% and 21% respectively. The risk for an individual woman with a high AVRI of developing a complication was increased by up to 9.8 times. Conclusion-Although Doppler screening does detect a unifying defect leading to perinatal death, pre-eclampsia, growth retardation and placental abruption, the predictive values do not yet justify its introduction as a routine test.

Impaired uteroplacental blood flow in pregnancies complicated by falciparum malaria

“…The association between abnormal uterine artery Doppler FVW and measures of bad obstetric outcome (PET, LBW and perinatal death) is in keeping with other studies 12,18,23,24 . Abnormalities of uterine artery Doppler FVW, persisting after 24 weeks of gestation, are predictive of subsequent pregnancy complications, including PET and IUGR 12,25 .…”

“…All Doppler FVW were either printed, or recorded on video. Abnormal uterine artery Doppler FVW ≥ 24 weeks were defined as bilateral/ ipsilateral early diastolic notches, or a mean /ipsilateral uterine artery RI value ≥ 0.58 12,18 . Notched or high resistance Doppler FVW prior to 24 weeks of gestation were not considered abnormal, since trophoblast invasion and transformation of the maternal vasculature may continue between 20 and 24 weeks of gestation in some normal pregnancies.…”

Three‐dimensional sonographic volumetry of the placenta and the fetus between weeks 15 and 17 of gestation

“…In addition to placental size several factors influence fetal growth including placental blood flow [2][3][4][5] , maternal height and weight [6][7][8] and maternal smoking habits. To investigate a complex system it is first necessary to look at its parts.…”

Assessment of fetal and placental blood flow in primates using contrast enhanced ultrasonography.

“…[5][6][7][8][9][10][11][12][13][14][15] Other studies have indicated the utility of color Doppler sonography for the assessment of placenta accreta and the identification of vasa previa. 16,17 The current study shows that the administration of Levovist enhances the color Doppler signal of the placenta.…”