First‐trimester uterine artery Doppler and adverse pregnancy outcome: a meta‐analysis involving 55 974 women

Abstract

Objectives To determine the accuracy with which uterine artery Doppler in the first trimester of pregnancy predicts pre-eclampsia and fetal growth restriction, particularly early-onset disease. MethodsWe searched MEDLINE (1951MEDLINE ( -2012, EMBASE (1980EMBASE ( -2012 (FVW) in the prediction of early-onset pre-eclampsia were , and in the prediction of early-onset fetal growth restriction were 39.2%

The usefulness of fetal Doppler evaluation in early versus late onset intrauterine growth restriction. Review of the literature.

“…From the maternal point of view, Doppler examination of the uterine arteries in the first and second trimester can confirm the presence of a vascular pathology and can anticipate its evolution [23]. The sensitivity of uterine Doppler examination in the first trimester upon any IUGR detection is 15.4% (95% CI: 12.4-18.9) with a high specificity 93.3% (95% CI: 90.9-95.1) [23].…”

“…The sensitivity of uterine Doppler examination in the first trimester upon any IUGR detection is 15.4% (95% CI: 12.4-18.9) with a high specificity 93.3% (95% CI: 90.9-95.1) [23]. The performance upon E-IUGR is better -sensibility -39.2% (95% CI: 26.3-53.8) and respectively specificity 93.1% (95% CI: 90.6-95.0) [23].…”

“…The use of Doppler evaluation of the uterine arteries during the first and second trimester of pregnancy represents a helpful tool for the prediction of IUGR [2,23,46,47].…”

New Definition of Fetal Growth Restriction: Consensus Regarding a Major Obstetric Complication

“…4 Some criticism regarding the parameters defined in the consensus included the use of uterine artery Doppler as a parameter associated with birth weight below the tenth percentile for diagnosing early FGR because uterine artery Doppler exhibited low sensitivity in a meta-analysis on the prediction of adverse perinatal events in FGR. 5 The cerebroplacental association in FGR has been extensively investigated. 6,7 The combined Doppler of the middle cerebral and umbilical arteries improves detection sensitivity relative to that of isolated Doppler.…”

Re: Consensus definition for placental fetal growth restriction: a Delphi procedure

“…Furthermore, a specific cut-off value is advocated (CPR < 5 th percentile), despite the fact that it is unclear which cut-off value on which CPR reference curve is optimal to reach maximum test accuracy 3 . Also, uterine artery Doppler is incorporated into their Delphi consensus, although its sensitivity was shown to be as low as 26% for adverse perinatal outcome in a meta-analysis involving 4513 patients 4 . By including these measurements in the diagnosis of FGR, as suggested in the Delphi consensus 1 , additional Doppler ultrasound measurements (uterine artery in early FGR and middle cerebral artery in late FGR) would be indicated in over 10% of pregnant women, which would have a large impact on clinical practice.…”