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

Abstract

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.

Role of Routine Mid-Trimester Uterine Artery Doppler for Surveillance of Placental Mediated Disorders in a Low-Risk Population

“…In line with the findings of the current study, Dhar et al conveyed meaningful outcomes in their study conducted in 2017, where elevated uterine artery PI, which was taken to be ≥95th percentile, had a clear association with pre-eclampsia and FGR (p-value=0.001) with an Sn of 35.7% and Sp of 98.2%. However, no association was found with spontaneous preterm labour, IUD and abruption [ 9 ]. Again, another study by Barati et al in 2012 also proved that abnormal uterine artery Doppler PI helped predict only hypertensive disorders and FGR but with good sensitivity and specificity of 79% and 95.5%, respectively, at a 95% confidence interval [ 10 ].…”

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

“… 23 In addition, scientific literature on Doppler studies shows that the uterine artery alone has been the major focus of attention in many studies evaluating the second or third trimester of pregnancy in predicting adverse pregnancy complications. 6–8 , 12 , 13 , 15 , 17 …”