title: Screening for pre-eclampsia and small for gestational age fetuses at the 11-14 weeks scan by uterine artery Dopplers.
abstract: OBJECTIVE
  To assess the role of uterine artery Doppler studies at 11-14 weeks in screening for pre-eclampsia (PET), small for gestational age (SGA) fetuses, and placental abruption.
  
  
  METHODS
  Prospective study on 1,123 women presenting for routine ultrasound examination at 11-14 weeks for nuchal translucency measurement. Uterine artery blood flow was studied by transvaginal colour Doppler, the mean pulsatility index (PI) was calculated, and the presence of a diastolic notch was recorded.
  
  
  RESULTS
  The mean, median and 95th centile of uterine artery PI were 1.71, 1.64 and 2.54, respectively. Bilateral notches were observed in 63.4%, and a unilateral notch in 18.4% of cases. The sensitivity of mean uterine artery PI>or=95th centile for PET, early onset severe PET necessitating delivery before 34 weeks, SGA<or=5th centile, SGA necessitating delivery before 34 weeks, SGA<or=10th centile and placental abruption were 21.4, 33.3, 17.8, 100, 9.6 and 44.4%, respectively. One in 6 women with increased resistance in the uterine arteries at 11-14 weeks will develop a complication related to utero-placental insufficiency.
  
  
  CONCLUSIONS
  Abnormal uterine Dopplers at 11-14 weeks identified one-third of women with severe early onset pre-eclampsia, all fetuses with SGA<or=5th centile that were delivered at<or=34 weeks, and 40% of cases with placental abruption. Uterine artery Doppler examination at the 11-14 weeks scan can identify a high risk population in which preventive or therapeutic interventions might be effective.
authors.affiliation: First Department of Obstetrics and Gyneacology, Alexandra Maternity Hospital, University of Athens, Athens, Greece. apilalis@yahoo.com
authors.forename: Athanasios
authors.initials: A
authors.lastname: Pilalis
authors.forename: Athena P
authors.initials: AP
authors.lastname: Souka
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Antsaklis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Basayiannis
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Benardis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Haidopoulos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papantoniou
authors.forename: Spyros
authors.initials: S
authors.lastname: Mesogitis
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000502:physiology*; D001783:Blood Flow Velocity; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D017078:Laser-Doppler Flowmetry; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D011673:Pulsatile Flow; D014599:Uterus / Q000098:blood supply*