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%

National Institute for Health Research and Medical Research Council.

ObjectiveTo determine the value of one-stop color Doppler imaging of the uterine arteries at the time of the 20-week anomaly scan, to select women at risk of developing pre-eclampsia and intrauterine growth restriction (IUGR).Patients and methods A total of 1022 unselected women had color Doppler imaging of both uterine arteries at the time of their dating/anomaly scan (19-21 weeks' gestation). The presence or absence of notching of the flow velocity waveform (FVW) was noted, and the resistance index (RI) was measured. The main outcome measures were pre-eclampsia, birth weight, placental abruption and stillbirth. ResultsThe outcome in 946 women (92.6%) was available for analysis. Of these, 216 (23%) had abnormal uterine artery Doppler studies, 117 (12.4%) with bilateral (right and left FVW) notches; 21 (2.2%) women developed preeclampsia, and 57 (6.0%) neonates were small for gestational age (SGA; < 5th centile), at birth. For women with bilateral notches the odds ratio (OR) for developing pre-eclampsia was 12.8 (95% confidence interval (CI) 5.3-30.8), and 52.6 (95% CI 6.4-430.1) for pre-eclampsia requiring delivery before 37 weeks' gestation. If the uterine artery Doppler studies were normal, the odds ratio for developing pre-eclampsia was 0.11 (95% CI 0.04-0.28), and 0.3 (95% CI 0.17-0.51) for the delivery of an SGA baby less than the 5th centile. In women with bilateral notches with mean RI greater than 0.55, the positive predictive value for the main outcome measures was 46%.Conclusion Women with normal uterine artery color/ pulsed Doppler studies at 20 weeks' gestation constitute a group that have a low risk of developing obstetric complications related to uteroplacental insufficiency. Women with high resistance in both uterine arteries (bilateral notches) have an increased risk of the subsequent development of such complications, in particular those requiring delivery before term. The addition of color Doppler imaging of the uterine arteries at the time of the routine 20-week dating/anomaly scan may be of use in determining the type and level of antenatal care that is offered to women.

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Combination of second-trimester serum inhibin-A and uterine artery Doppler at 20 weeks improves the screening efficacy for the prediction of pre-eclampsia especially when this necessitates early delivery. This combination might form the basis of an effective and practical early screening test for the condition.

The study was planned to determine the proportion of parents that wish to know the sex of their fetus at the 20-week anomaly scan, and to investigate our ability to diagnose correctly the sex of the fetus when undertaken as part of a routine scan. A total of 472 patients gave their informed consent. An attempt was made to identify the genitalia as part of the routine scan. No extra time was allowed to determine the sex of the fetus. Altogether 353 (74.7%) women wanted to know the sex, of which four (0.9%) wanted to know but did not want their partners to know. In 50 (10.6%) cases, it was not possible to determine the fetal sex in the time allowed. When the sex was identified, it was correct in 408 (96.7%) cases, and incorrect in 14 (3.3%) cases. Where the parents wanted to know the sex of the fetus, 24 (6.8%) scans were inconclusive, 319 (97%) were correctly identified, and ten (3%) were incorrectly identified (six male, four female). There were no terminations of pregnancy. The majority of prospective parents wish to know the sex of their child, and, in most cases, it is possible to determine the fetal sex at the time of the routine anomaly scan. During the time allowed, the fetal sex was undetermined in one in ten cases, and 3% were sexed incorrectly. If parents wish to know the gender of their fetus, it would appear reasonable to provide this information, provided that the parents are aware of the failure and error rates of sex identification using ultrasound.