title: Significance of uteroplacental Doppler at midtrimester in patients with favourable obstetric history.
abstract: OBJECTIVE
  To reassess the usefulness of midtrimester uterine Doppler in low-risk multiparous women.
  
  
  METHODS
  We prospectively recruited low-risk pregnant women at 20-22 weeks attending our clinic. Among those, women with a favourable obstetric history (group A) were distinguished from nulliparous (group B) and of each group we measured uterine artery Doppler (pulsatility index (PI)). We evaluated the accuracy of uterine artery Doppler in the prediction of preeclampsia and small for gestational age (SGA) neonates.
  
  
  RESULTS
  Between January 2009 and October 2010, 382 women were included in the study of which 147 in group A and 235 in group B. Overall, 26/382 (6.8%) women presented preeclampsia and SGA occurred in 59/382 (15.4%) cases. In our population, at a 10% false positive rate (FPR) uterine artery Doppler showed a detection rate (DR) of 19.2% for preeclampsia and of 37.3% for SGA, with a higher sensitivity for SGA neonates delivered ≤ vs. >34 weeks (87% vs. 29.4%). The univariable receiver operating characteristics (ROC) curve by uterine artery PI yielded a significant prediction only for SGA in nulliparous women (areas under the curve (AUC) of 0.70; 95% CI 0.60-0.79).
  
  
  CONCLUSIONS
  Our data confirmed that midtrimester uterine artery Doppler is not an efficient strategy in anticipating the risk of pregnancy complications among low-risk multiparous women.
authors.affiliation: Department of Obstetrics and Gynaecology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Arcangeli
authors.forename: Francesca
authors.initials: F
authors.lastname: Giorgetta
authors.forename: Antonio
authors.initials: A
authors.lastname: Farina
authors.forename: Francesca
authors.initials: F
authors.lastname: De Musso
authors.forename: Federica
authors.initials: F
authors.lastname: Bellussi
authors.forename: Ginevra
authors.initials: G
authors.lastname: Salsi
authors.forename: Elisa
authors.initials: E
authors.lastname: Montaguti
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Pilu
authors.forename: Nicola
authors.initials: N
authors.lastname: Rizzo
authors.forename: Tullio
authors.initials: T
authors.lastname: Ghi
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology; D021041:Placental Circulation / Q000502:physiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000209:etiology; D011262:Pregnancy Trimester, Second / Q000502:physiology; D017584:Reproductive History; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods