Doppler ultrasound screening as part of routine antenatal scanning: Prediction of pre‐eclampsia and intrauterine growth retardation

Bower, S.; Schuchter, K.; Campbell, Stuart

doi:10.1016/0020-7292(94)90440-5

Cited by 63 publications

(94 citation statements)

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“…It is unlikely that changing the de®nition of an abnormal uterine Doppler would substantially change its predictive value 22 . The percentage of abnormal Doppler results reported was similar or a little higher in our study than in other large prospective studies in the same type of popu-lation at the same gestational age 8,22,23 . We cannot hope, however, to improve the test's sensitivity and increase the number of at-risk patients treated with aspirin simply by reducing the number of abnormal uterine Doppler results by using a stricter de®nition, even if the positive predictive value would then be higher.…”

Section: Discussionsupporting

confidence: 85%

Screening with a uterine Doppler in low risk pregnant women followed by low dose aspirin in women with abnormal results: a multicenter randomised controlled trial

Goffinet

Aboulker

Paris-Llado

et al. 2001

BJOG

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Collaborators and participating centres of the French Doppler study group are listed on page 517.Objectives To assess whether systematic screening with an uterine artery Doppler in low risk pregnant women followed by the prescription of low dose aspirin in cases with abnormal results reduced the incidence of intrauterine growth restriction and pre-eclampsia.Design A multicentre randomised trial.Population 3317 low risk pregnant women. In the Doppler group, the uterine artery Doppler was performed between 20 and 24 weeks. Women with abnormal results received 100 mg of aspirin daily until the 35th week. Main outcome measures Intrauterine growth restriction was de®ned as birthweight below the tenth and the third centile according to gestational age. Pre-eclampsia was de®ned as hypertension associated with proteinuria . 0.5g/L.Results Intrauterine growth restriction, whether de®ned by the third or tenth centile, did not differ signi®cantly between the two groups (RR 1.22 [0.73 -2.04] and 1.18 [0.93 -1.51] respectively). Screening with uterine artery Doppler did not affect birthweight or any of the criteria of perinatal morbidity. There was no effect on the incidence of pre-eclampsia (RR 1.99 [0.97 -4.09]) or hypertensive disorders. These results were the same for nulliparae and multiparae. Conclusions There is no justi®cation for screening with uterine artery Doppler in a low risk population, even if abnormal results are followed by aspirin treatment and increased prenatal surveillance. Future studies must assess predictive tests that can be performed early in pregnancy and can identify populations at very high risk of pre-eclampsia and intrauterine growth restriction. Only when all of these conditions are ful®lled, aspirin or other treatments may prove its ef®cacy.

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Section: Discussionsupporting

confidence: 85%

Screening with a uterine Doppler in low risk pregnant women followed by low dose aspirin in women with abnormal results: a multicenter randomised controlled trial

Goffinet

Aboulker

Paris-Llado

et al. 2001

BJOG

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“…Abnormal umbilical artery velocity waveforms have also been associated with an increased risk of perinatal morbidity and mortality. 4 Doppler investigation of the umbilical artery, therefore, can provide essential information regarding the fetoplacental circulation.…”

Section: Abbreviationsmentioning

confidence: 99%

Combination of Fetal Doppler Velocimetric Resistance Values Predict Acidemic Growth-Restricted Neonates

Hung

Fu²,

Hung

2006

Journal of Ultrasound in Medicine

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Objective. This study was undertaken to determine the efficacy of combination Doppler velocimetric resistance values of the umbilical artery and ductus venosus in predicting growth-restricted neonates with acidemia. Methods. This retrospective case-control study included 61 gravidas complicated by intrauterine growth restriction with acidemia and 65 control pregnancies. The Doppler velocimetric resistance values obtained from the growth-restricted and control fetuses were in turn compared with the median values derived from another 192 normal pregnancies to adjust the biometric bias due to gestational age. Results. Based on the pulsatility index of the umbilical artery and pulsatility index for the vein of the ductus venosus, the areas under the receiver operating characteristic curves were 0.7992 and 0.6749, respectively, for predicting growth-restricted neonates with acidemia. With a combination of the pulsatility indices of the umbilical artery and the pulsatility indices for the vein of the ductus venosus, the predictive accuracy of the growth-restricted neonates with acidemia increased, with sensitivity of 0.79 and specificity of 0.79 and an area under the receiver operating characteristic curve of 0.8441. Conclusions. Compared with single-vessel assessment, combining the pulsatility indices of the umbilical artery and the pulsatility indices for the vein of the ductus venosus provides the greatest accuracy in predicting growth-restricted neonates with acidemia.

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“…[3][4][5][6][7][8] However, despite numerous studies, the role of UtA Doppler velocimetry to predict preeclampsia and FGR in the low-risk obstetric population still remains uncertain. Although the report from Bower et al 6 demonstrated that low-risk women with an abnormal UtA waveform had a 24-fold increased risk of developing moderate/severe preeclampsia, their good results could not be reproduced in other studies. The relationship between UtA Doppler velocimetry and perinatal outcome, specifically birth weight, is even more controversial, as some authors have found a moderate but still significant correlation.…”

Section: Introductionmentioning

confidence: 99%

“…The relationship between UtA Doppler velocimetry and perinatal outcome, specifically birth weight, is even more controversial, as some authors have found a moderate but still significant correlation. 3,4,6,7,9,10 Several methods to evaluate UtA blood flow velocity waveforms have been proposed. The vast majority of studies have used the pulsatility index (PI) during the second trimester of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

First‐trimester uterine artery Doppler velocimetry in the prediction of birth weight in a low‐risk population

et al. 2012

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Our study found a clinically significant correlation between the lowest UtA PI value and birth weight in an unselected, low-risk pregnant population. Because fetal growth is a multifactorial process in which placentation is only one of the factors involved, the use of a single parameter such as Doppler velocimetry remote from the delivery to predict birth weight in a low-risk population seems to be less useful than in the high-risk population.

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Doppler ultrasound screening as part of routine antenatal scanning: Prediction of pre‐eclampsia and intrauterine growth retardation

Cited by 63 publications

References 0 publications

Screening with a uterine Doppler in low risk pregnant women followed by low dose aspirin in women with abnormal results: a multicenter randomised controlled trial

Screening with a uterine Doppler in low risk pregnant women followed by low dose aspirin in women with abnormal results: a multicenter randomised controlled trial

Combination of Fetal Doppler Velocimetric Resistance Values Predict Acidemic Growth-Restricted Neonates

First‐trimester uterine artery Doppler velocimetry in the prediction of birth weight in a low‐risk population

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