One-stage screening for pregnancy complications by color Doppler assessment of the uterine arteries at 23 weeks' gestation

Albaigés, G.; Missfelder-Lobos, Hannah; Lees, C.; Parra, M.; Nicolaides, Kypros H.

doi:10.1016/s0029-7844(00)00946-7

Cited by 287 publications

(276 citation statements)

References 6 publications

Supporting

Mentioning

247

Contrasting

Unclassified

Order By: Relevance

“…Uterine Doppler waveforms analysis has become a valuable tool in the evaluation of the placental circulation and in the prediction of pregnancy outcome. Increased placental vascular impedance is frequently related to FGR and pregnancy-induced hypertension, 1,3,6,[7][8][9][10][11][12] which are still unsolved severe clinical problems associated with an increased maternal and perinatal mortality and morbidity. Maternal uterine artery Doppler in the second trimester of pregnancy helps the obstetricians to select patients at high risk for these complications but with a too low positive predictive value.…”

Section: Discussionmentioning

confidence: 99%

“…xtensive research over the past 20 years has evaluated the use of uterine artery Doppler evaluation in the second [1][2][3][4][5][6] trimesters of pregnancy as a screening tool to predict the later development of preeclampsia, fetal growth restriction (FGR), placental abruption, and stillbirth. Since the introduction of uterine artery Doppler as an early screening test for complications in pregnancy in the mid-1980s, conflicting results on its value have been reported as discussed by Papageorghiou et al 4 The persistence of bilateral notches in uterine arteries associated with a quantitative resistance index cutoff at 24 weeks' gestation was reported to improve screening efficacy to identify patients at risk for complications in pregnancy.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Total Vascular Resistance and Left Ventricular Morphology as Screening Tools for Complications in Pregnancy

Vasapollo¹,

Novelli²,

Valensise³

2008

Hypertension

View full text Add to dashboard Cite

Abstract-We evaluated the predictive value of elevated total vascular resistance on the outcome of pregnancy in normotensive high-risk primigravidas with bilateral notching of the uterine artery Doppler. A total of 526 high-risk primigravidas referred to the obstetrics outpatient clinic of Tor Vergata University with bilateral notching of the uterine artery at 20 to 22 weeks' gestation were submitted to a maternal echocardiographic examination and uterine artery Doppler evaluation at 24 weeks' gestation. Blood pressure was recorded at the time of the examination, total vascular resistance was calculated, and the geometric pattern of the left ventricle was assessed. Patients were followed until the end of pregnancy to detect fetal/maternal adverse outcomes (gestational hypertension, preeclampsia, abruptio placentae, fetal growth restriction, perinatal death, etc). A total of 111 of the 526 pregnancies showed a bilateral notch at 24 weeks' gestation, and 97 had an adverse outcome (18.44%). The best independent predictor for maternal and fetal complications was total vascular resistance (odds ratio: 91.25; 95% CI: 39.64 to 210.05; PϽ0.001). The cutoff value was 1400 dynes ⅐ s ⅐ cm Ϫ5, with a sensitivity and a specificity of 89% and 94%, respectively. A high relative wall thickness of the left ventricle (Ͼ0.37; odds ratio: 2.47; 95% CI: 1.12 to 5.44) and a hypertrophized ventricle (left ventricular mass Ͼ130 g; odds ratio: 2.52; 95% CI: 1.12 to 5.64) were also independent predictors (PϽ0.05). Echocardiography might identify at 24 weeks' gestation patients who subsequently develop maternal and fetal complications through the assessment of maternal hemodynamics and left ventricular geometry. (Hypertension. 2008;51:1020-1026.)

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Total Vascular Resistance and Left Ventricular Morphology as Screening Tools for Complications in Pregnancy

Vasapollo¹,

Novelli²,

Valensise³

2008

Hypertension

View full text Add to dashboard Cite

show abstract

“…Test performance for prediction of IUGR in twin pregnancies can be similarly examined and also appears slightly worse than in singletons 1,2,7 . However, it is clear from studies examining mid-trimester uterine artery Doppler indices in singleton pregnancies, that although detection rates for all cases of PET and IUGR may be only about 50%, the real value of this investigation is in the identification of those severe cases that require delivery before 34 weeks of gestation for which the sensitivity of increased pulsatility index or notching is about 80%−95% 3,7,17,18 . Identification of this small but highly clinically relevant group is the aim of uterine artery Doppler screening; unfortunately, the current studies in twin pregnancies do not provide data on sensitivities for PET or IUGR by gestational age to allow comparisons to be made, but future larger studies will hopefully also demonstrate a similar high detection rate with a low false positive rate for those with severe disease in twins.…”

mentioning

confidence: 99%

Routine uterine artery Doppler screening in twin pregnancies?

Sebire

2002

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

“…7,8,12,13 Mean of PI in patients with adverse pregnancy outcome was 1.2±0.3. that was significantly higher as compared to those with no adverse outcome (0.857±0.179).…”

Section: Discussionmentioning

confidence: 93%

“…[5][6][7][8] The aim of this study was to determine the sensitivity, specificity, positive and negative predictive value of the uterine artery PI at 23-24 weeks in the prediction of adverse pregnancy outcome in our study population.…”

Section: Introductionmentioning

confidence: 99%

Value of PI of uterine artery at 23-24 weeks in the prediction of adverse pregnancy outcome

Dhar

Kaul

2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Increased resistance in uteroplacental circulation is associated with pregnancy complications. The aim of this study was to determine the role of uterine artery PI at 23-24 weeks gestation in predicting adverse pregnancy outcomes.Methods: 200 singleton pregnancies were prospectively examined with color Doppler to determine the PI of uterine artery at 23-24 weeks and study its correlation with subsequent development of adverse maternal and fetal outcomes defined as any or the combination of preeclampsia, intrauterine growth restriction (IUGR), intrauterine death (IUD), preterm delivery and placental abruption.Results: There were 13 cases (6.5%) with abnormal uterine artery Doppler results and 8 (61.5%) of them developed preeclampsia, out of these 8, 1 had IUGR as well and 3 had iatrogenic preterm delivery due to severe preeclampsia. 2 (15.4%) out of 13 had only IUGR. The pregnancies with adverse outcomes had significantly higher mean PI than those with normal outcomes (1.2±0.3 versus 0.857±0.179; p <0.001). The sensitivity, specificity, PPV and NPV of PI ≥95th percentile in the prediction of adverse pregnancy outcome was 35.71%, 98.26%, 76.92% and 90.37% respectively. The birth weight in higher mean PI group was significantly lower than in pregnancies with PI <95th percentile (2.33±0.49 kg versus 2.86±0.48 kg; p <001). No cases of spontaneous preterm labor, IUD or abruption were present in higher mean PI group.Conclusions: Increased uterine artery PI at 23-24 weeks of pregnancy is associated with an increased risk of adverse pregnancy outcomes.

show abstract

One-stage screening for pregnancy complications by color Doppler assessment of the uterine arteries at 23 weeks' gestation

Cited by 287 publications

References 6 publications

Total Vascular Resistance and Left Ventricular Morphology as Screening Tools for Complications in Pregnancy

Total Vascular Resistance and Left Ventricular Morphology as Screening Tools for Complications in Pregnancy

Routine uterine artery Doppler screening in twin pregnancies?

Value of PI of uterine artery at 23-24 weeks in the prediction of adverse pregnancy outcome

Contact Info

Product

Resources

About