Uterine artery Doppler screening as a predictor of pre-eclampsia

Casmod, Yasmin; Dyk, Barbara van; Nicolaou, E

doi:10.4102/hsag.v21i0.996

Cited by 3 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Different studies have reported varying frequencies of PE and related findings on Doppler U/S [ 10 ]. A study has observed high impedance flow in the uterine artery in about 40% of pregnant mothers, who subsequently developed PE [ 11 ]. It has also been reported that after a positive ultrasound scan on notching or impedance to flow of uterine arteries, the likelihood for PE increases by about two folds.…”

Section: Discussionmentioning

confidence: 99%

Role of Uterine Artery Doppler Ultrasound in Predicting Pre-Eclampsia in High-Risk Women

Shahid¹,

Masood²,

Bano³

et al. 2021

Cureus

View full text Add to dashboard Cite

Background and objectivePre-eclampsia (PE) is a major cause of maternal morbidity and mortality. The utility of Doppler ultrasonography (U/S) in predicting PE has not been extensively explored. This study aimed to determine the role of Doppler U/S in predicting PE among high-risk women. MethodologyThis was a retrospective observational study conducted at the Department of Obstetrics and Gynecology of Abbasi Shaheed Hospital in Karachi, over a period of one year, from January 2019 till December 2019. A total of 325 women were initially screened for risk factors for PE. Among them, 75 women were eventually found to have risk factors for PE and hence included in the study. Uterine artery Doppler U/S was performed to evaluate uterine artery's flow velocity waveforms. They were then used to calculate the presence of diastolic notch and resistance index (RI). At each antenatal visit, the risk factors for PE such as BP, proteinuria, and signs and symptoms were noted. Women were labeled to have PE if they developed hypertension (BP >140/90) after 20 weeks of gestation in combination with proteinuria. ResultsTwenty women (28%) had a normal Doppler flow of the uterine arteries. In 54 (72%) women, a unilateral/bilateral RI >0.58 was observed, and 29 women (38.7%) had a bilateral Rl >0.58. Notching of the uterine artery was also observed in 42 (26.7%, unilateral/bilateral) and in 22 (29.3%) bilaterally. Among the 75 women, BP of 140/90 mmHg along with proteinuria was observed in 56 (76.7%) cases, which were hence diagnosed as PE. Based on the cutoff of Rl and notching of the uterine artery, the overall sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of Doppler U/S in predicting PE were 71.4%, 26.3%, 23.8%, and 74.1%, respectively. As far as individual Doppler U/S indices were concerned, RI >0.58 (unilateral/bilateral) was found to be most sensitive (71%), while the presence of uterine artery notch (unilateral/bilateral) was most specific in predicting PE. ConclusionAbnormal Doppler U/S has good overall sensitivity in predicting PE. Among individual Doppler indices, notching of uterine arteries had a better specificity compared to high RI.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of Uterine Artery Doppler Ultrasound in Predicting Pre-Eclampsia in High-Risk Women

Shahid¹,

Masood²,

Bano³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…Previously, Casmod et al had reported that in the second trimester, only one out of seven patients with preeclampsia had a PI value above the 95th percentile, while in the third trimester, two out of the seven patients had a PI value above the 95th percentile. 44 Furthermore, our finding also suggests using different Doppler parameters and cutoffs for different adverse pregnancy outcomes. This observation is similar to what Rabiu and Abubakar 45 reported by using second-trimester umbilical RI to predict adverse pregnancy outcomes and different optimum cutoff points for various hypertensive disorders following ROC.…”

Section: Discussionmentioning

confidence: 62%

Utilization of Uterine and Umbilical Artery Doppler in the Second and Third Trimesters to Predict Adverse Pregnancy Outcomes: A Nigerian Experience

Adekanmi

Roberts

Morhason-Bello

et al. 2022

Women's Health Reports

View full text Add to dashboard Cite

Objective: To assess the utility of uterine and umbilical artery Doppler in the second and third-trimester in predicting adverse pregnancy outcomes. Methodology: In a prospective longitudinal study, the demographic, clinical, Doppler ultrasound parameters of the uterine and umbilical arteries of 84 consecutive women attending the antenatal clinic at 22–24 weeks and 116 women at 30–34 weeks gestation and pregnancy outcomes were documented and analyzed. Results: Pregnant women with adverse pregnancy outcomes had significantly higher second-trimester mean uterine systolic/diastolic (S/D) ratio ( p = 0.001), pulsatility index (PI; p = 0.003), umbilical artery S/D ( p = 0.016), and resistivity index (RI; p = 0.041) as well as higher third-trimester uterine S/D and PI. While pregnancies with adverse fetal outcomes showed significantly higher uterine artery S/D and PI at the second trimester, third-trimester uterine showed higher S/D, RI, and PI and umbilical artery PI than in women with normal fetal outcomes. The combination of uterine PI and early diastolic notch were predictors of maternal outcomes and correctly predicted 73% ( p < 0.001) in the second trimester. By the third trimester, the uterine PI alone was the best predictor and accurately predicted about 62% of maternal outcomes ( p = 0.028). In addition, the second-trimester uterine S/D and early diastolic notch and uterine PI in the third trimester correctly predicted 79% and 78% of fetal outcomes, respectively. Conclusion: Among unselected pregnant women population, the second-trimester Doppler parameters are better predictors of maternal adverse pregnancy outcomes, while adverse fetal outcome prediction by uterine and umbilical Doppler at the second- and the third-trimester parameters are comparable.

show abstract

“…However, the sensitivity of the test and the recommendations for using it as a routine screening tool are highly inconclusive [6,7]. Few studies recommend UtA Doppler screening only in the high risk group and have observed an increased risk of adverse pregnancy outcomes in that group [4,8].…”

Section: Introductionmentioning

confidence: 99%

Uterine artery Doppler: Changing Concepts in Prediction and Prevention of PE and FGR

Lakshmy

Masilamani

Umapathy

et al. 2018

Journal of Fetal Medicine

View full text Add to dashboard Cite

One of the most promising screening tools in detection of PE and FGR is uterine artery Doppler velocimetry. The underlying pathology for the development of PE is thought to be due to defective trophoblastic invasion of uterine spiral arteries. Increased impedance during mid-trimester is known to be associated with a high incidence of adverse pregnancy outcomes. High resistance in uterine arteries can be observed as early in the first trimester in cases with impaired placentation. The predictive efficacy of first trimester UtA Doppler has improved after the development of risk specific algorithm by including maternal characteristics, biophysical and biochemical parameters. With the understanding of late onset FGR and PE, it was realised that first trimester UtA Doppler may not serve as an efficient marker to identify this group which led to the evolution of its assessment in third trimester. The importance of UtA Doppler in third trimester is its ability to differentiate a physiologically small baby from a pathologically small fetus, which is growth restricted. PE and FGR remains an important cause of maternal and fetal mortality and its prediction is a challenging task which needs to be done early in gestation.Low dose aspirin when started before 16 weeks in the truly high risk population has proven to significantly reduce PE and FGR. To initiate aspirin therapy, the development of first trimester risk prediction model remains the key component. This paper is a review of the predictive efficacy of UtA Doppler in detecting uteroplacental insufficiency in each of the three trimesters.

show abstract

Uterine artery Doppler screening as a predictor of pre-eclampsia

Cited by 3 publications

References 0 publications

Role of Uterine Artery Doppler Ultrasound in Predicting Pre-Eclampsia in High-Risk Women

Role of Uterine Artery Doppler Ultrasound in Predicting Pre-Eclampsia in High-Risk Women

Utilization of Uterine and Umbilical Artery Doppler in the Second and Third Trimesters to Predict Adverse Pregnancy Outcomes: A Nigerian Experience

Uterine artery Doppler: Changing Concepts in Prediction and Prevention of PE and FGR

Contact Info

Product

Resources

About