title: Second trimester uterine artery Doppler screening in prediction of adverse pregnancy outcome in high risk women.
abstract: OBJECTIVE
  To assess the value of uterine artery colour Doppler waveform analysis in the prediction of adverse pregnancy outcome such as preeclampsia, fetal growth restriction in high risk pregnancy women.
  
  
  METHODS
  Uterine artery Doppler screening was performed as part of mid trimester screening between 20 and 24 weeks gestation in high risk pregnancy women at Matermal Fetal Medicine unit, Thammasat University Hospital between June 1, 2008 and May 31, 2009. A pulsatility index (PI) was calculated from each uterine artery and the presence or absence of a notch was determined. A PI of > 1.58 or the presence of any diastolic notch were defined as abnormal. The main outcome measures were pre-eclampsia and small for gestational aged baby (birth weight < 10th centile).
  
  
  RESULTS
  Doppler examination of the uterine arteries were performed in 330 singleton pregnancies. Twenty-seven (8.18%) women developed pre-eclampsia, 16 (4.84%) women had SGA babies. The sensitivity ofPI > 1.58 and diastolic notch for preeclampsia, SGA were 59.25% and 56.25%, respectively.The specificity of PI >1.58 and diastolic notch for these outcomes were 66.67% and 65.60% respectively.
  
  
  CONCLUSIONS
  In high-risk women, mid trimester uterine artery Doppler waveform analysis can not use as screening method in women at higher risk for the development of severe adverse outcome such as pre-eclampsia and SGA babies. However women with normal uterine artery Doppler results are unlikely to develop pre-eclampsia, fetal growth restriction (FGR) and therefore do not necessarily need repeated Doppler ultrasound follow-up.
authors.affiliation: Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. pongrojpaw@hotmail.com
authors.forename: Densak
authors.initials: D
authors.lastname: Pongrojpaw
authors.forename: Athita
authors.initials: A
authors.lastname: Chanthasenanont
authors.forename: Tongta
authors.initials: T
authors.lastname: Nanthakomon
mesh_terms: D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008403:Mass Screening; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging* / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*; D016216:Ultrasonography, Prenatal / Q000379:methods; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D014599:Uterus / Q000098:blood supply / Q000000981:diagnostic imaging