| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
ORIGINAL RESEARCH |
From Harris Birthright Research Centre for Fetal Medicine, King’s College Hospital, London, United Kingdom.
Address reprint requests to: Christoph Lees, MD Harris Birthright Research Centre for Fetal Medicine King’s College Hospital, Denmark Hill London SE5 9RS United Kingdom E-mail: cclees{at}compuserve.com
Objective: To estimate the value of screening for preeclampsia and fetal growth restriction by performing color Doppler assessment of uterine arteries at 23 weeks’ gestation in predicting adverse pregnancy outcome.
Methods: Women with singleton pregnancies who attended routine ultrasonography at 23 weeks had color Doppler uterine artery imaging. Bilateral uterine artery notches were noted and left and right uterine artery pulsatility indices (PI) were measured. A mean PI of more than 1.45 was considered increased. Screening characteristics for predicting preeclampsia and delivery of small-for-gestational-age infants were calculated.
Results: Of 1757 pregnancies, increased PI was present in 89 (5.1%) and bilateral notches were noted in 77 (4.4%). Twenty-three of 65 women (35.3%; 95% confidence interval [CI] 23.9, 48.2) had increased PI and later developed preeclampsia, and 8 of 10 (80%; 95% CI 44.4, 97.5) with preeclampsia required delivery before 34 weeks. The respective values for women with bilateral notches were 21 of 65 (32.3%; 95% CI 21.2, 45.1) and 8 of 10 (80%; 95% CI 44.4, 97.5). The sensitivity of increased PI was 30 of 143 (21%; 95% CI 14.6, 28.6) for delivery of an infant with birth weight below the tenth percentile and 7 of 10 (70% 95% CI 34.8,93.3) for birth weight below the tenth percentile delivered before 34 weeks. The respective values for bilateral notches were 19 of 143 (13.3%; 95% CI 8.2, 20) and 5 of 10 (50%; 95% CI 18.7, 81.3).
Conclusion: A one-stage color Doppler screening program at 23 weeks identified most women who subsequently developed serious complications of impaired placentation associated with delivery before 34 weeks. The screening results were similar when the high-risk group was defined as women with increased PI or bilateral notches.
This article has been cited by other articles:
|
|
 |
|
  B. Vasapollo, G. P. Novelli, and H. Valensise Total Vascular Resistance and Left Ventricular Morphology as Screening Tools for Complications in Pregnancy Hypertension, April 1, 2008; 51(4): 1020 - 1026. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. C.S. Smith, E. Celik, M. To, O. Khouri, K. H. Nicolaides, and the Fetal Medicine Foundation Second Trimester Scr Cervical Length at Mid-Pregnancy and the Risk of Primary Cesarean Delivery N. Engl. J. Med., March 27, 2008; 358(13): 1346 - 1353. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. McLeod MD How useful is uterine artery Doppler ultrasonography in predicting pre-eclampsia and intrauterine growth restriction? Can. Med. Assoc. J., March 11, 2008; 178(6): 727 - 729. [Full Text] [PDF]
|
|
|
|
 |
|
 G. C. S. Smith, C. K. H. Yu, A. T. Papageorghiou, A. M. Cacho, K. H. Nicolaides, and for the Fetal Medicine Foundation Second Trimester Maternal Uterine Artery Doppler Flow Velocimetry and the Risk of Stillbirth Obstet. Gynecol., January 1, 2007; 109(1): 144 - 151. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Alberry and P Soothill Management of fetal growth restriction Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2007; 92(1): F62 - F67. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. E. Murphy, R. Smith, W. B. Giles, and V. L. Clifton Endocrine Regulation of Human Fetal Growth: The Role of the Mother, Placenta, and Fetus Endocr. Rev., April 1, 2006; 27(2): 141 - 169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Conde-Agudelo, J. Villar, and M. Lindheimer World Health Organization Systematic Review of Screening Tests for Preeclampsia Obstet. Gynecol., December 1, 2004; 104(6): 1367 - 1391. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Frusca, M. Soregaroli, C. Platto, L. Enterri, A. Lojacono, and A. Valcamonico Uterine Artery Velocimetry in Patients With Gestational Hypertension Obstet. Gynecol., July 1, 2003; 102(1): 136 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. M. Reis, D. D'Antona, and F. Petraglia Predictive Value of Hormone Measurements in Maternal and Fetal Complications of Pregnancy Endocr. Rev., April 1, 2002; 23(2): 230 - 257. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Lyall, H. Simpson, J. Nicola Bulmer, A. Barber, and S. Courtenay Robson Transforming Growth Factor-{beta} Expression in Human Placenta and Placental Bed in Third Trimester Normal Pregnancy, Preeclampsia, and Fetal Growth Restriction Am. J. Pathol., November 1, 2001; 159(5): 1827 - 1838. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Lees, M. Parra, H. Missfelder-Lobos, A. Morgans, O. Fletcher, and K. H. Nicolaides Individualized Risk Assessment for Adverse Pregnancy Outcome by Uterine Artery Doppler at 23 Weeks Obstet. Gynecol., September 1, 2001; 98(3): 369 - 373. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
