Preeclampsia--abnormal uterine artery Doppler is related to recurrence of symptoms during the next pregnancy.
BACKGROUND
Impaired trophoblast invasion is suggested as the main cause of reduced placental perfusion, which results in fetal growth restriction and preeclampsia. Immunological response against the invading tissue has been given as the explanation. Preeclampsia frequently recurs during the next pregnancy. Doppler ultrasound can predict increased vascular impedance in the uteroplacental circulation. Whether signs of increased vascular resistance in pregnancies complicated by preeclampsia are predictive of recurrence during the next pregnancy is unknown.


METHODS
Uterine artery Doppler was performed in 570 pregnant women with preeclampsia. Of these, 139 became pregnant again. The uterine artery Doppler results during the first pregnancy were related to symptoms of preeclampsia in the succeeding pregnancy.


RESULTS
Preeclampsia developed again in 43 of the 139 women. Pregnancies with signs of increased uterine artery vascular impedance during the first pregnancy were 3.4 times more likely to develop preeclampsia again (CI 1.58-7.6). Similar results for a small for gestational age newborn were 9.7 (CI 1.1-90).


CONCLUSIONS
Increased uterine artery vascular impedance in pregnancies complicated by preeclampsia increases the likelihood of recurrence and growth restriction during the next pregnancy. The Doppler information gathered during the first pregnancy might thus select cases for special surveillance and possibly prophylactic anti-platelet treatment in the next pregnancy.
Gudnasson
Haraldur M
HM
Department of Obstetrics and Gynecology, University Hospital MAS, Malmö, Sweden.
Dubiel
Mariusz
M
Gudmundsson
Saemundur
S
D000328:Adult; D001158:Arteries / Q000502:physiology; D001783:Blood Flow Velocity; D015331:Cohort Studies; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011673:Pulsatile Flow; D012008:Recurrence; D018608:Ultrasonography, Doppler / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging