Delayed normalisation of uterine artery doppler waveforms is not a benign phenomenon

Kurdi, Wesam; Fayyad, Abdalla; Thakur, Vidya; Harrington, Kevin

doi:10.1016/j.ejogrb.2003.10.038

Cited by 25 publications

(23 citation statements)

References 15 publications

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“…They suggested reassessment of uterine artery Doppler at 26 to 28 weeks in those with increased resistance in the second trimester of pregnancy as we also concluded. Kurdi et a. reported late normalization was not a benign process as it was associated with adverse pregnancy outcome [33]. Similarity Lai et al showed that the testing of uterine artery at 30-33 weeks could effectively identify women at risk for subsequent development of preeclampsia [13].…”

Section: Discussionsupporting

confidence: 52%

Multicenter screening for adverse pregnancy outcomes by uterine artery Doppler in the second and third trimester of pregnancy

Jamal¹

2013

Med Ultrason

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Aims: Increased uterine artery pulsatility index (PI) is associated with adverse pregnancy outcomes. The aim of the study was to determine the role of uterine artery PI at 18-24 and 30-34 weeks, gestation in predicting adverse pregnancy outcomes. Material and methods: Color Doppler assessment of the uterine arteries was carried out in 435 consecutive women attending an antenatal clinic at 18-24 weeks and in 134 women at 30-34 weeks. The 95th percentiles of the mean uterine PI and the presence or the absence of bilateral notches was recorded. Using the reference range, performance characteristics in the prediction of pregnancy outcomes were calculated. Association of mean PI at 30-34 weeks with pregnancy outcomes also was studied. The adverse pregnancy outcomes were defined as any or the combination of pre-eclampsia, fetal growth restriction, intrauterine fetal death, preterm delivery and placental abruption. Results: The women with adverse pregnancy outcomes had significant higher mean PI (1.27±0.55 vs. 0.99±0.32; p=0.003) and higher prevalence of bilateral notch (20% vs. 4.6%, p=0.001) than those with normal outcomes. The mean (±SD) PI in women with severe adverse outcome was 1.66±0.66 vs. 1.0±0.32 in women with normal pregnancy outcome (p=0.002). For a screen positive rate of 10.6% (mean PI>95th percentile for gestational age and/or bilateral notches), the sensitivity for predicting an adverse outcome was 33.3%. The sensitivity increased to 60% for predicting a severe adverse outcome. Increased resistance in the third trimester was also associated with an adverse pregnancy outcome Conclusion: Increased uterine artery PI in second and third trimester of pregnancy is associated with an increased risk of adverse pregnancy outcomes.

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Section: Discussionsupporting

confidence: 52%

Multicenter screening for adverse pregnancy outcomes by uterine artery Doppler in the second and third trimester of pregnancy

Jamal¹

2013

Med Ultrason

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“…[4][5][6][7] Normal placentation involves successful trophoblastic invasion of maternal decidua, myometrium, and blood vessels, particularly the spiral arteries, which are invaded by extravillous trophoblasts, modifying the endothelial lining and the media and generating a progressive dilatation. 8,9 Maternal spiral arteries, which are small-caliber vasoreactive vessels, are transformed into flaccid, distended uteroplacental arteries, creating a lowresistance vascular bed with a high blood flow. [8][9][10][11] Defective trophoblastic invasion has been linked to several pregnancy complications, including preeclampsia, IUGR, small for gestational age (SGA) fetus, and early pregnancy failure.…”

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confidence: 99%

“…8,9 Maternal spiral arteries, which are small-caliber vasoreactive vessels, are transformed into flaccid, distended uteroplacental arteries, creating a lowresistance vascular bed with a high blood flow. [8][9][10][11] Defective trophoblastic invasion has been linked to several pregnancy complications, including preeclampsia, IUGR, small for gestational age (SGA) fetus, and early pregnancy failure. 4,9,[12][13][14] The use of Doppler sonography to analyze blood flow in even terminal branches of the uteroplacental circulation encouraged investigators to try and predict early and late pregnancy complications related to abnormal placentation.…”

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confidence: 99%

Doppler examination of uteroplacental circulation in early pregnancy: Can it predict adverse outcome?

Özkaya

Özkan

Özeren

et al. 2007

J of Clinical Ultrasound

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“…High rates of falsepositive test results at 20 weeks have led some to delay screening until 23-24 weeks. 9,11,12 This approach will detect both those women with persistent abnormalities and those with late normalization, which has been associated with lower birth weight and increased rates of small for gestational age (SGA) neonates. Another drawback of performing the uterine Doppler at 24 weeks is that this gestation is too late for interventions to reduce the risk of the most severe cases of preeclampsia.…”

mentioning

confidence: 99%

Patterns of Change in Uterine Artery Doppler Studies Between 20 and 24 Weeks of Gestation and Pregnancy Outcomes

Groom

North

Stone

et al. 2009

Obstetrics & Gynecology

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Delayed normalisation of uterine artery doppler waveforms is not a benign phenomenon

Cited by 25 publications

References 15 publications

Multicenter screening for adverse pregnancy outcomes by uterine artery Doppler in the second and third trimester of pregnancy

Multicenter screening for adverse pregnancy outcomes by uterine artery Doppler in the second and third trimester of pregnancy

Doppler examination of uteroplacental circulation in early pregnancy: Can it predict adverse outcome?

Patterns of Change in Uterine Artery Doppler Studies Between 20 and 24 Weeks of Gestation and Pregnancy Outcomes

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