Screening for pre‐eclampsia and small for gestational age fetuses at the 11–14 weeks scan by uterine artery Dopplers

Pilalis, Athanasios; Souka, Athena P.; Antsaklis, Panagiotis; Basayiannis, Konstantinos; Benardis, Panayiotis; Haidopoulos, Dimitrios; Papantoniou, Nikolaos; Mesogitis, S.; Antsaklis, Aris

doi:10.1080/00016340601155056

Cited by 74 publications

(43 citation statements)

References 34 publications

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“…In a larger study Pilalis et al measured the uterine artery blood flow in 1123 pregnant women at 11 to 14 weeks of gestation. 7 The outcome of this study was unambiguous: The sensitivity of uterine artery Doppler for all cases of preeclampsia was only 21%, and it was 33.3% for early onset preeclampsia cases. The sensitivity for detection of early onset of fetal growth restriction in this study, however, was 100%.…”

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confidence: 96%

Placental Origins of Preeclampsia

2008

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confidence: 96%

Placental Origins of Preeclampsia

2008

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“…Uterine artery Doppler examination at the 11 to 14 weeks scan can identify a high risk population in which preventive or therapeutic interventions might be effective. 10 Another study undertaken to evaluate the association between uterine artery Doppler velocimetry performed between 10 and 14 weeks gestation and intrauterine growth restriction. The uterine artery mean RI for the entire cohort was equal on the right and left sides (0.59 ± 0.14).…”

Section: Ijifmmentioning

confidence: 99%

Predicting Obstetric Vasculopathies through Study of Diastolic Notch and other Indices of Resistance to Blood Flow in Uterine Artery

Desai¹

2013

International Journal of Infertility &Amp; Fetal Medicine

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Obstetric vasculopathies are a set of apparently heterogeneous and poorly understood conditions. Conditions like recurrent miscarriages due to fetal demise, pre-eclampsia, IUGR, recurrent still births and accidental hemorrhage all seem to have the same underlying etiopathology. They are grouped into one large set coined as 'Obstetric Vasculopathies'. Resistance to blood flow in the uterine arteries can be important and effective method to predict obstetric vasculopathies (except recurrent miscarriages). Resistance to this blood flow can be measured by the presence (and subsequent disappearance) of diastolic notch as well as the standard color Doppler indices namely Pulsatility Index (PI), Resistance Index (RI) and Systolic: Diastolic (S: D) ratio. In normal pregnancy almost always at 12 to 14 weeks of duration, the uterine artery shows presence of a diastolic notch. In high-risk subjects, disappearance of diastolic notch at midtrimester in uterine artery Doppler waveform analysis if used alone may not be a good screening method for obstetric vasculopathies. However, the combination of a diastolic notch and an abnormal resistance index in both uterine arteries at 20 weeks gestation is more accurate indicator in predicting severe pregnancy complications. These subjects are almost eight times more likely to develop either: Clinically significant hypertension and/or deliver prior to 32 weeks and/or have a perinatal demise and/or have an Infant with a birth weight of less than 1500 gm. Bilateral or Unilateral: Studying bilateral uterine artery seems to be more accurate that unilateral artery for prediction of obstetric vasculopathies. Prediction in I-Trimester: Disappearance of uterine artery diastolic notch in combination with other parameters seems to be a good test for prediction of obstetric vasculopathies particularly PIH and IUGR in I-Trimester. The advantage of such an early allows an early instituting of preventive measures. Notch Depth Index (NDI): It is calculated as the depth of the diastolic notch divided by the maximal diastolic velocity. The NDI value in the second trimester is associated with the later onset of pre-eclampsia, and is clinically more useful in predicting pre-eclampsia than the two conventional indices. Abnormal maternal uterine artery Doppler in association with elevated maternal serum AFP, HCG, Inhibin A or decreased PAPP-A identifies a group of subjects at greater risk of IUGR and gestational hypertension with proteinuria. Lowdose aspirin administered as early as 14 to 16 weeks of gestation to pregnant subjects at high risk of pre-eclampsia with abnormal uterine Doppler findings may reduce or modify the course of severe pre-eclampsia and may help in prevention of IUGR.

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“…Cooper et al (17) conducted a study in 229 pregnant women and underlined the value of an increased mean uterine artery PI measured at the 22 nd week of pregnancy in predicting preterm birth, the small for gestational age (SGA), and a low birth weight, particularly in pregnant women with a PAPP-A value lower than 0.4 MoM. Pilalis et al (18) evaluated 878 pregnant women on the 11 th -14 th weeks of pregnancy and emphasized that each of the Doppler ultrasound of uterine arteries and the PAPP-A value is an independent factor for predicting SGA and that the combination of both is more effective for prediction. The present study, showing an inverse relation between uterine artery PI and birth weight, differs from the other studies in that uterine artery PI has been evaluated within a different gestational age period of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Predictive values of maternal serum PAPP-A level, uterine artery Doppler velocimetry, and fetal biometric measurements for poor pregnancy and poor neonatal outcomes in pregnant women

Balcı

2016

J Turkish German Gynecol Assoc

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Screening for pre‐eclampsia and small for gestational age fetuses at the 11–14 weeks scan by uterine artery Dopplers

Abstract: Abnormal uterine Dopplers at 11-14 weeks identified one-third of women with severe early onset pre-eclampsia, all fetuses with SGA

Cited by 74 publications

References 34 publications

Placental Origins of Preeclampsia

Placental Origins of Preeclampsia

Predicting Obstetric Vasculopathies through Study of Diastolic Notch and other Indices of Resistance to Blood Flow in Uterine Artery

Predictive values of maternal serum PAPP-A level, uterine artery Doppler velocimetry, and fetal biometric measurements for poor pregnancy and poor neonatal outcomes in pregnant women

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