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  • Title: Transabdominal uterine artery Doppler between 11 and 14 weeks of gestation for the prediction of outcome in high-risk pregnancies.
    Author: Fratelli N, Rampello S, Guala M, Platto C, Frusca T.
    Journal: J Matern Fetal Neonatal Med; 2008 Jun; 21(6):403-6. PubMed ID: 18570118.
    Abstract:
    OBJECTIVE: To assess the value of early transabdominal uterine artery Doppler ultrasound for the prediction of gestational outcomes in pregnancies at high risk for preeclampsia. METHODS: This was an observational study. Doppler ultrasound of the uterine arteries at 11-14 weeks of gestation was performed in 76 women at high risk for preeclampsia. Abnormal uterine Doppler was defined by the presence of bilateral notching or by a mean resistance index (RI) >0.80. Adverse outcomes evaluated were preeclampsia, fetal growth restriction, placental abruption, intrauterine death, and complications requiring delivery before 34 weeks of gestation. RESULTS: Among 76 women, 30 (39%) had abnormal uterine Doppler and 46 (61%) had normal Doppler waveform configuration and RI. Abnormal uterine flow was related to a significantly higher incidence of preeclampsia (17% vs. 0%; p = 0.0041), fetal growth restriction (27% vs. 0%; p = 0.0002), intrauterine death (13% vs. 0%; p = 0.0109), and iatrogenic preterm delivery (20% vs. 2%; p = 0.0086). When the Doppler was normal, the negative predictive value for complications requiring delivery before 34 weeks was 98%. CONCLUSIONS: Normal impedance to flow in uterine arteries between 11 and 14 weeks of gestation is strongly related to a normal pregnancy outcome in women at high risk for preeclampsia.
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