Screening for pre-eclampsia and small for gestational age fetuses at the 11-14 weeks scan by uterine artery Dopplers.
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.
Pilalis
Athanasios
A
First Department of Obstetrics and Gyneacology, Alexandra Maternity Hospital, University of Athens, Athens, Greece. apilalis@yahoo.com
Souka
Athena P
AP
Antsaklis
Panayiotis
P
Basayiannis
Konstantinos
K
Benardis
Panayiotis
P
Haidopoulos
Dimitrios
D
Papantoniou
Nikolaos
N
Mesogitis
Spyros
S
Antsaklis
Aris
A
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*