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

Groom, Katie; North, Robyn A.; Stone, Peter; Chan, Eliza; Taylor, Rennae S.; Dekker, Gustaaf A.; McCowan, Lesley

doi:10.1097/aog.0b013e318195b223

Cited by 45 publications

(37 citation statements)

References 18 publications

(18 reference statements)

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“…It is however striking that hypertensive disorders was not the most common in the study contrary to reports from other studies [5, 8, 10]. This could be an indication that the cases of hypertensive disorders seen in the locality may not be due mainly to impaired placentation.…”

Section: Discussioncontrasting

confidence: 88%

“…In addition to the factors discussed above, another potential reason for the absence of difference in indices between normal and abnormal pregnancies relates to the heterogeneity of aetiologies of the complications, which is not usually considered in many studies design [10]. This also contributes to the apparent poor sensitivity and specificity in some studies [5, 10]. …”

Section: Discussionmentioning

confidence: 99%

“…A large number of researches have investigated the potentials of second trimester uterine artery Doppler studies as a screening tool for these complications [4–6]. Although research findings are not uniformly in favour of its use, because of the heterogeneity of the aetiology of complications of impaired placentation, there are however important evidences to justify the application of presently used indices for routine screening [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

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Uterine artery Doppler study in second trimester of pregnancy

Oloyede¹,

Iketubosin²

2013

Pan Afr Med J

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IntroductionThe uterine artery Doppler has potentials for screening for complications of impaired placentation. This study examines the indices of uterine artery impedance at 22-23 weeks gestation and their relationship with maternal age and parity.MethodsUterine artery colour imaging and pulsed wave Doppler ultrasound was conducted between 22nd and 23rd weeks in 430 pregnancies. The pregnancies were classified into 2 groups: normal and abnormal outcomes. The indices of impedance recorded were pulsatility index, resistance index and the systolic/diastolic ratio. Relevant obstetric information was retrieved from the antenatal records. The student t- test and Pearson's product moment were used for statistical analysis.ResultsFifty eight (13.5%) out of 430 pregnancies had complications of impaired placentation, mainly intrauterine growth restriction and preterm birth (24 or 41.4% each). The indices in normal pregnancies were similar to presently used values. There was no statistically significant difference in the 2 pregnancies groups. The Pulsatility Index (PI) in the right uterine artery was statistically different from the left (t-test 32.8, p < 0.05). Maternal age and parity demonstrate statistically significant positive correlation with PI (r =0.9, p < 0.05; r =0.8, p < 0.05).ConclusionThe indices in normal pregnancies were similar to values from previous studies. The values are however not significantly different in pregnancies with abnormal outcome.

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Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Uterine artery Doppler study in second trimester of pregnancy

Oloyede¹,

Iketubosin²

2013

Pan Afr Med J

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“…Ultrasound examination at 20±1 weeks’ gestation included measurements of the fetus (biparietal diameter, head circumference, abdominal circumference and femur length), Doppler studies of the umbilical and uterine arteries, and transvaginal cervical length measurements [12]. Notching of each uterine artery was recorded.…”

Section: Methodsmentioning

confidence: 99%

Risk Factors for Preterm Birth in an International Prospective Cohort of Nulliparous Women

et al. 2012

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ObjectivesTo identify risk factors for spontaneous preterm birth (birth <37 weeks gestation) with intact membranes (SPTB-IM) and SPTB after prelabour rupture of the membranes (SPTB-PPROM) for nulliparous pregnant women.DesignProspective international multicentre cohort.Participants3234 healthy nulliparous women with a singleton pregnancy, follow up was complete in 3184 of participants (98.5%).ResultsOf the 3184 women, 156 (4.9%) had their pregnancy complicated by SPTB; 96 (3.0%) and 60 (1.9%) in the SPTB-IM and SPTB-PPROM categories, respectively. Independent risk factors for SPTB-IM were shorter cervical length, abnormal uterine Doppler flow, use of marijuana pre-pregnancy, lack of overall feeling of well being, being of Caucasian ethnicity, having a mother with diabetes and/or a history of preeclampsia, and a family history of low birth weight babies. Independent risk factors for SPTB-PPROM were shorter cervical length, short stature, participant’s not being the first born in the family, longer time to conceive, not waking up at night, hormonal fertility treatment (excluding clomiphene), mild hypertension, family history of recurrent gestational diabetes, and maternal family history of any miscarriage (risk reduction). Low BMI (<20) nearly doubled the risk for SPTB-PPROM (odds ratio 2.64; 95% CI 1.07–6.51). The area under the receiver operating characteristics curve (AUC), after internal validation, was 0.69 for SPTB-IM and 0.79 for SPTB-PPROM.ConclusionThe ability to predict PTB in healthy nulliparous women using clinical characteristics is modest. The dissimilarity of risk factors for SPTB-IM compared with SPTB-PPROM indicates different pathophysiological pathways underlie these distinct phenotypes.Trial RegistrationACTR.org.au ACTRN12607000551493

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“…Ultrasound examination performed at 20±1 weeks’ gestation included fetal anthropometric measurements (biparietal diameter, femur length and head and abdominal circumference) and Doppler waveform analysis of the umbilical and uterine arteries [12]. Mean uterine resistance index (RI) was calculated from the left and right uterine RI.…”

Section: Methodsmentioning

confidence: 99%

Clinical Prediction in Early Pregnancy of Infants Small for Gestational Age by Customised Birthweight Centiles: Findings from a Healthy Nulliparous Cohort

et al. 2013

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ObjectiveSmall for gestational age (SGA) infants comprise up to 50% of all stillbirths and a minority are detected before birth. We aimed to develop and validate early pregnancy predictive models for SGA infants.Methods5628 participants from SCOPE, a prospective study of nulliparous pregnant women, were interviewed at 15±1 weeks’ gestation. Fetal anthropometry, uterine and umbilical Doppler studies were performed at 20±1 weeks’. The cohort was divided into training (n = 3735) and validation datasets (n = 1871). All-SGA (birthweight <10th customised centile), Normotensive-SGA (SGA with normotensive mother) and Hypertensive-SGA (SGA with mother who developed hypertension) were the primary outcomes. Multivariable analysis was performed using stepwise logistic regression firstly using clinical variables and then with clinical and ultrasound variables. Receiver operator curves were constructed and areas under the curve (AUC) calculated.Results633 infants (11.3%) in the whole cohort were SGA; 465 (8.3%) Normotensive-SGA and 165 (3.0%) Hypertensive-SGA. In the training dataset risk factors for All-SGA at 15±1 weeks’ included: family history of coronary heart disease, maternal birthweight <3000 g and 3000 g to 3499 g compared with ≥3500 g, >12 months to conceive, university student, cigarette smoking, proteinuria, daily vigorous exercise and diastolic blood pressure ≥80. Recreational walking ≥4 times weekly, rhesus negative blood group and increasing random glucose were protective. AUC for clinical risk factors was 0.63. Fetal abdominal or head circumference z scores <10th centile and increasing uterine artery Doppler resistance at 20±1 weeks’ were associated with increased risk. Addition of these parameters increased the AUC to 0.69. Clinical predictors of Normotensive and Hypertensive-SGA were sub-groups of All-SGA predictors and were quite different. The combined clinical and ultrasound AUC for Normotensive and Hypertensive-SGA were 0.69 and 0.82 respectively.ConclusionPredictors for SGA of relevance to clinical practice were identified. The identity and predictive potential differed in normotensive women and those who developed hypertension.

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

Abstract: II.

Cited by 45 publications

References 18 publications

Uterine artery Doppler study in second trimester of pregnancy

Uterine artery Doppler study in second trimester of pregnancy

Risk Factors for Preterm Birth in an International Prospective Cohort of Nulliparous Women

Clinical Prediction in Early Pregnancy of Infants Small for Gestational Age by Customised Birthweight Centiles: Findings from a Healthy Nulliparous Cohort

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