The effect of gestational age and placental location on the prediction of pre‐eclampsia by uterine artery Doppler velocimetry in low‐risk nulliparous women

Antsaklis, A.; Daskalakis, G.; Tzortzis, Emmanouil; Michalas, S.

doi:10.1046/j.1469-0705.2000.00288.x

Cited by 54 publications

(50 citation statements)

References 16 publications

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“…The correlation between RI of Ut.A and gestational age was not significant in the current study (0.026 with a P = 0.795). This agrees with findings of Antasklis 21 who found the physiological process of trophoblastic invasion is reflected in the observation from Doppler studies that impedance to flow in the uterine arteries decreases with gestation between 6 and 24 weeks and remains constant thereafter, so no changes occur with advancing gestational age. The most frequently affected number of arteries as revealed by Doppler studies was three abnormal arteries in the gestational age between 26-34 weeks, one abnormal artery between 35-38 weeks, and two abnormal arteries between 39-42 weeks.…”

Section: Discussionsupporting

confidence: 81%

Doppler ultrasound in intrauterine growth retardation and its indices in correlation with gestational age

Othman¹,

Saeed

2017

ZJMS

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Section: Discussionsupporting

confidence: 81%

Doppler ultrasound in intrauterine growth retardation and its indices in correlation with gestational age

Othman¹,

Saeed

2017

ZJMS

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“…Screening at 20 weeks has a higher sensitivity than screening at 24 weeks (81 vs 76%), but lower specificity (87 vs 95%). 3 One study studied the longitudinal variation in uterine artery blood flow pattern in relation to birth weight. In this study the relationship between the timing of disappearance of high-resistance uterine artery waveforms between the first and second trimester of pregnancy and birth weight was focused upon.…”

Section: Diastolic Notch As a Predictor Of Obstetric Vasculopathiesmentioning

confidence: 99%

Predicting Obstetric Vasculopathies through Study of Diastolic Notch and other Indices of Resistance to Blood Flow in Uterine Artery

Desai¹

2013

International Journal of Infertility &Amp; Fetal Medicine

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Obstetric vasculopathies are a set of apparently heterogeneous and poorly understood conditions. Conditions like recurrent miscarriages due to fetal demise, pre-eclampsia, IUGR, recurrent still births and accidental hemorrhage all seem to have the same underlying etiopathology. They are grouped into one large set coined as 'Obstetric Vasculopathies'. Resistance to blood flow in the uterine arteries can be important and effective method to predict obstetric vasculopathies (except recurrent miscarriages). Resistance to this blood flow can be measured by the presence (and subsequent disappearance) of diastolic notch as well as the standard color Doppler indices namely Pulsatility Index (PI), Resistance Index (RI) and Systolic: Diastolic (S: D) ratio. In normal pregnancy almost always at 12 to 14 weeks of duration, the uterine artery shows presence of a diastolic notch. In high-risk subjects, disappearance of diastolic notch at midtrimester in uterine artery Doppler waveform analysis if used alone may not be a good screening method for obstetric vasculopathies. However, the combination of a diastolic notch and an abnormal resistance index in both uterine arteries at 20 weeks gestation is more accurate indicator in predicting severe pregnancy complications. These subjects are almost eight times more likely to develop either: Clinically significant hypertension and/or deliver prior to 32 weeks and/or have a perinatal demise and/or have an Infant with a birth weight of less than 1500 gm. Bilateral or Unilateral: Studying bilateral uterine artery seems to be more accurate that unilateral artery for prediction of obstetric vasculopathies. Prediction in I-Trimester: Disappearance of uterine artery diastolic notch in combination with other parameters seems to be a good test for prediction of obstetric vasculopathies particularly PIH and IUGR in I-Trimester. The advantage of such an early allows an early instituting of preventive measures. Notch Depth Index (NDI): It is calculated as the depth of the diastolic notch divided by the maximal diastolic velocity. The NDI value in the second trimester is associated with the later onset of pre-eclampsia, and is clinically more useful in predicting pre-eclampsia than the two conventional indices. Abnormal maternal uterine artery Doppler in association with elevated maternal serum AFP, HCG, Inhibin A or decreased PAPP-A identifies a group of subjects at greater risk of IUGR and gestational hypertension with proteinuria. Lowdose aspirin administered as early as 14 to 16 weeks of gestation to pregnant subjects at high risk of pre-eclampsia with abnormal uterine Doppler findings may reduce or modify the course of severe pre-eclampsia and may help in prevention of IUGR.

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“…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

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The effect of gestational age and placental location on the prediction of pre‐eclampsia by uterine artery Doppler velocimetry in low‐risk nulliparous women

Cited by 54 publications

References 16 publications

Doppler ultrasound in intrauterine growth retardation and its indices in correlation with gestational age

Doppler ultrasound in intrauterine growth retardation and its indices in correlation with gestational age

Predicting Obstetric Vasculopathies through Study of Diastolic Notch and other Indices of Resistance to Blood Flow in Uterine Artery

Routine uterine artery Doppler screening in twin pregnancies?

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