The predictive capacity of uterine artery Doppler for preterm birth—A cohort study

Zijl, Maud D. van; Koullali, Bouchra; Mol, Ben W.; Snijders, R. J. M.; Kazemier, Brenda M.; Pajkrt, Eva

doi:10.1111/aogs.13770

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…When assessed in the 1 st and 2 nd trimester, uterine artery Doppler flow did not present a significant correlation with spontaneous preterm delivery compared with maternal demographic characteristics and previous obstetric history. 33,34 In our study, there was no significant correlation between uterine artery Doppler and cervical length; therefore, there is probably no association with preterm delivery due to a short cervix.…”

Section: Discussioncontrasting

confidence: 55%

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Women's Obstetric History and Midtrimester Cervical Length Measurements by 2D/3D and Doppler Ultrasound

Marinelli

Filho

Barros

et al. 2020

Rev Bras Ginecol Obstet

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Objective The aim of the present study was to compare the obstetric history and both two- and tri-dimensional ultrasound parameters according to different cervical lengths. Methods The present cross-sectional study analyzed 248 midtrimester pregnant women according to cervical length and compared the data with the obstetric history and 2D/3D ultrasound parameters. Patients were divided into 3 groups according to cervical length: The Short Cervix group for cervical lengths ≥ 15 mm and < 25 mm (n = 68), the Very Short Cervix group for cervical lengths < 15 mm (n = 18) and the Control group, composed of 162 pregnant women with uterine cervical lengths ≥ 25 mm. Results When analyzing the obstetric history of only non-nulliparous patients, a significant association between the presence of a short cervix in the current pregnancy and at least one previous preterm birth was reported (p = 0.021). Cervical length and volume were positively correlated (Pearson coefficient = 0.587, p < 0.0001). The flow index (FI) parameter of cervical vascularization was significantly different between the Control and Very Short Cervix groups. However, after linear regression, in the presence of volume information, we found no association between the groups and FI. Uterine artery Doppler was also not related to cervical shortening. Conclusion The present study showed a significant association between the presence of a short cervix in the current pregnancy and at least one previous preterm birth. None of the vascularization indexes correlate with cervical length as an independent parameter. Uterine artery Doppler findings do not correlate with cervical length.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Women's Obstetric History and Midtrimester Cervical Length Measurements by 2D/3D and Doppler Ultrasound

Marinelli

Filho

Barros

et al. 2020

Rev Bras Ginecol Obstet

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“…With the widespread use of colour Doppler ultrasound in prenatal diagnosis in recent years, clinical research in obstetrics and gynecology has gradually focused on the relationship between maternal and fetal ultrasound blood flow parameters, as well as the occurrence and progression of adverse pregnancy outcomes. Ultrasound detection indices can now be used as supplemental indices for HDCP diagnosis and treatment [19][20][21]. Abnormal UA spectrum is associated with placental 3rd-grade villous stem occlusion.…”

Section: Comparison Of Mean Age and Gestational Age Amongmentioning

confidence: 99%

Fetal and Neonatal Middle Cerebral Artery Hemodynamic Changes and Significance under Ultrasound Detection in Hypertensive Disorder Complicating Pregnancy Patients with Different Severities

Zhou¹,

Sun²,

Tan³

et al. 2022

Computational and Mathematical Methods in Medicine

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Colour Doppler ultrasound was applied for monitoring the hemodynamic parameters of fetal uterine artery (UtA), umbilical artery (UA), and middle cerebral artery (MCA) during pregnancy. In hypertension disease complicating pregnancy, these hemodynamic measures and their therapeutic applicability value were reviewed (HDCP). 120 singleton pregnant women were chosen, with 40 cases of mild preeclampsia (mild group), 40 cases of severe preeclampsia (severe group), and 40 normal control pregnant women (control group). The hemodynamic parameters of UtA, MCA, and UA were monitored in the three groups, including pulsatility index (PI), resistance index (RI), and the systolic/diastolic velocity (S/D). The parameters PI, RI, S/D, and venous catheter shunt rate (Qdv/Quv) of UtA and UA in the severe group were higher than those in the normal group and the mild group, showing the differences statistically significant ( P < 0.05 ). The PI, RI, and S/D of MCA in the severe group were lower than those in the normal group and the mild group ( P < 0.05 ). The changing trends of PI, RI, and S/D in the severe group were all first increased and then decreased in the early, middle, and later pregnancy ( P < 0.05 ). The area under the curve (AUC) was 0.98 in the receiver operating characteristic (ROC) curve created using a combination of hemodynamic measures and pregnancy outcomes, and the sensitivity and specificity for predicting bad outcomes were 94.7 percent and 96.4 percent, respectively. Colour Doppler ultrasound may accurately detect changes in the PI, RI, and S/D of UtA, MCA, and UA in pregnant women and serve as a reference for determining the intrauterine state of the fetuses and predicting bad pregnancy outcomes. In particular, the parameters in later pregnancy were higher worthy of diagnostic value for adverse pregnancy outcomes. The combination of various parameters could make an improvement of the diagnostic accuracy and provide a basis for guiding treatment as well as determining the optimal timing of delivery.

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“…Ultrasound parameters such as a short cervical length and the pulsatility index of the uterine artery have also been assessed from the perspective of PTB, but the results have been conflicting [ 15 , 16 , 17 ]. In a secondary analysis conducted by Grobman and colleagues, a short cervical length (<30 mm) on transvaginal ultrasound in the second trimester, between 16 and 22 weeks of gestation, achieved an AUC value of only 0.63 in the prediction of spontaneous PTB before 34 weeks of gestation [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Predicting Preterm Birth with Strain Ratio Analysis of the Internal Cervical Os: A Prospective Study

Luca,

Haba,

Cobzeanu

et al. 2023

JCM

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(1) Background: Cervical elastography is a new concept that could allow clinicians to assess cervical consistency in various clinical scenarios. We aimed to evaluate the predictive performance of the strain ratio (SR) at the level of the internal os, either individually or in combination with other parameters, in the prediction of spontaneous preterm birth (PTB) at various gestational ages. (2) Methods: This prospective study included 114 pregnant patients with a high-risk profile for PTB who underwent cervical elastography during the second trimester. Clinical and paraclinical data were assessed using univariate analysis, logistic regression, and sensitivity analysis. (3) Results: The SR achieved an area under the receiver operating curve (AUROC) value of 0.850, a sensitivity of 85.71%, and a specificity of 84.31% in the prediction of PTB before 37 weeks of gestation. The combined model showed superior results in terms of accuracy (AUROC = 0.938), sensitivity (92.31%), and specificity (95.16%). When considering PTB subtypes, the highest AUROC value (0.80) and accuracy (95.61%) of this marker were achieved in the prediction of extremely preterm birth, before 28 weeks of gestation. (4) Conclusions: The SR achieved an overall good predictive performance in the prediction of PTB and could be further evaluated in various cohorts of patients.

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The predictive capacity of uterine artery Doppler for preterm birth—A cohort study

Cited by 5 publications

References 27 publications

Women's Obstetric History and Midtrimester Cervical Length Measurements by 2D/3D and Doppler Ultrasound

Women's Obstetric History and Midtrimester Cervical Length Measurements by 2D/3D and Doppler Ultrasound

Fetal and Neonatal Middle Cerebral Artery Hemodynamic Changes and Significance under Ultrasound Detection in Hypertensive Disorder Complicating Pregnancy Patients with Different Severities

Predicting Preterm Birth with Strain Ratio Analysis of the Internal Cervical Os: A Prospective Study

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