Uterine Artery Doppler Ultrasonography for First Trimester Prediction of Preeclampsia in Individuals at Risk from Low-Resource Settings

Abstract

Background and objectives: The objective of this study was to evaluate the potential of first trimester uterine artery Doppler ultrasonography for the early prediction of preeclampsia (PE), in at-risk pregnant women. Materials and Methods: This was a prospective longitudinal study, including 120 Caucasian pregnant women with risk factors for PE. The potential of pulsatility indexes (PI) and notch was assessed as a tool for preeclampsia screening. Results: Doppler examination of the uterine artery performed early at 11–14 WA allows the detection of pregnancies that will develop PE with a sensitivity of 61.5% and a specificity of 63.8% based on PI analysis. Predictive power increases slightly by adding bilateral notch (sensitivity = 65.4%; specificity = 66%). Conclusions: Uterine artery Doppler examination is an effective non-invasive screening test for the development of PE in pregnancies at risk, particularly appropriate in health systems with limited means of evaluating other biomarkers.

Screening of High-Risk Patient by Uterine Artery Doppler Analysis in The 1st Trimester to Predict Early Onset Pre-Eclampsia

“…The data obtained in this study also showed that in PE screening, in patients at high risk, Doppler examination of the uterine artery performed early at 12-13 weeks allows the detection of pregnancies that will develop PE with a sensitivity of 75% and a specificity of 79% based on PI analysis. The results of our study are in agreement with other studies which, analyzing Doppler changes in the first trimester of pregnancy, reported similar detection rates of overall PE, with a higher prediction for early onset PE (<34 weeks) (18,24,25) . The present study showed that the best cutoff value of uterine artery PI for the prediction of early onset preeclampsia was ≥ 2.03 with accuracy of 79% and AUC of 76%.…”

“…These findings are in consistency with the findings of Spencer et al (26) and Plasencia et al (23) , in which the uterine artery mean PI in the second trimester correctly predicts about 79% and 67% of all cases of PE. These values were slightly lower than what was documented by Adekanmi et al (11) , and higher than that documented by Oancea et al (18) , they reported AUC values of 86.2% and 62.12%, respectively. In the study of Yıldırım et al (12) , a comparable cutoff value was determined.…”

“…Liu et al (14) described in their study findings that among 412 Taiwanese with gestational hypertensive disorders; preeclampsia was developed in 88.3% of the high risk women. In their study, Adekanmi et al (11) , Liu et al (14) and Oancea et al (18) did not exclude participants with hypertension or other comorbidities; and this might account for the observed high discrepancy in the proportion of women developed preeclampsia in their study relative to the low finding in the present study.…”

“…In contrast, Adekanmi et al (11) , among the Nigerian women studied, 62.2% of women with high risk pregnancy had preeclampsia with or without other complications. In the Oancea et al (18) study, the investigators explored the hypothesis that a basic, routinely performed procedure, first-trimester ultrasound monitoring, may provide a window of opportunity for screening for preeclampsia using a standalone biomarker, in pregnant women with known risk factors for the disorder. Therefore, they studied the potential of first trimester uterine artery Doppler ultrasonography for the early prediction of PE, in at-risk pregnant women.…”

A Review of Roles of Uterine Artery Doppler in Pregnancy Complications

“…According to this article ( 55 ), UAD at 11–14 weeks can confirm most pregnant women who will have PE and/or FGR. A prospective research involved 120 Caucasian pregnant women with high-risk factors for PE at 11–14 gestational weeks ( 70 ). Accordingly, the predictive sensitivity of UtA-PI for PE was 61.5, and the specificity was 63.8% ( 70 ).…”