title: First trimester maternal uterine artery Doppler examination in HIV-positive women.
abstract: OBJECTIVE
  The aim of the current study was to assess the effect of maternal HIV infection, treated or untreated, on the degree of placental invasion, as assessed by the pulsatility index of the uterine arteries during a Doppler examination at 11(+0) -13(+6)  weeks' gestation.
  
  
  METHODS
  This was a nested case-control study in which a uterine artery Doppler examination was performed in the first trimester in 76 HIV-positive women. Each woman was matched with 30 HIV-negative women. As the pulsatility index of the uterine arteries depends on a number of maternal and fetal characteristics, its values in each case and control were expressed as multiples of the median (MoM) of the unaffected group.
  
  
  RESULTS
  Among the 76 HIV-positive women, 33 (43.4%) were on antiretroviral treatment at the time of the Doppler examination, including 14 women (42.4%) on nucleoside reverse transcriptase inhibitors (NRTIs) and a protease inhibitor, 18 women (54.5%) on NRTIs and a nonnucleoside reverse transcriptase inhibitor and one woman (3.1%) on monotherapy. Compared with the HIV-negative women, the HIV-positive women were more likely to be heavier (P<0.01), to be of African origin (P<0.01), to be nonsmokers (P=0.01) and to deliver smaller neonates earlier (P<0.01). The median adjusted pulsatility index of the uterine arteries was not statistically different between the cases and controls [1.07; interquartile range (IQR) 0.85-1.24 MoM vs. 0.99; IQR 0.81-1.20 MoM; P= 0.28] or, in HIV-positive women, between those receiving and not receiving antiretroviral treatment (P=0.12).
  
  
  CONCLUSIONS
  HIV-positive women with uncomplicated pregnancies have normal placental perfusion in the first trimester of pregnancy.
authors.affiliation: Department of Maternal Fetal Medicine, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, UK. msavvidou@dsla.ndo.co.uk
authors.forename: M D
authors.initials: MD
authors.lastname: Savvidou
authors.forename: M I
authors.initials: MI
authors.lastname: Samuel
authors.forename: R
authors.initials: R
authors.lastname: Akolekar
authors.forename: M
authors.initials: M
authors.lastname: Poulton
authors.forename: K H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D011261:Pregnancy Trimester, First; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000503:physiopathology
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors