title: Prediction of recurrent preeclampsia using first-trimester uterine artery Doppler.
abstract: OBJECTIVE
  To evaluate the role of first-trimester uterine artery Doppler in the prediction of recurrent preeclampsia (PE).
  
  
  METHODS
  Uterine artery pulsatility index (UtPI) was measured at 11 to 13 weeks' gestation in 1,810 women with singleton pregnancies who had developed PE in a previous pregnancy. They were categorized into three subgroups according to UtPI multiple of median (MoM): < 1.0, 1.0 to 1.49, and ≥ 1.50 MoM. The rate of early onset PE (< 34 weeks), intermediate PE (34 to 36 weeks), late PE (≥ 37 weeks), perinatal death, and small-for-gestational-age outcome (SGA; below the 5th percentile) were compared between each subgroup.
  
  
  RESULTS
  The median mean UtPI decreased with advancing crown-rump length (CRL) from 1.77 at CRL of 45 to 54 mm to 1.52 at CRL of 75 to 84 mm. UtPI < 1.0 MoM was associated with a low-risk of early PE (0.2%), intermediate PE (0.3%), perinatal death (0.3%), and SGA (3.3%). The risk for these complications increases with UtPI of 1.0 to 1.4 MoM or ≥ 1.5 MoM (early PE 2.8 and 14.3%, respectively, p < 0.001; intermediate PE 2.1 and 5.4%, p < 0.001; perinatal death 1.3 and 6.8%, p < 0.001; and SGA 8.0 and 20.9%, p < 0.001).
  
  
  CONCLUSIONS
  In women with previous PE, first-trimester UtPI discriminates women at high and low risk for recurrence of PE and adverse pregnancy outcomes.
authors.affiliation: Departments of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Quebec City, Canada.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Demers
authors.affiliation: Departments of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Quebec City, Canada.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bujold
authors.affiliation: Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, United Kingdom.
authors.forename: Edgar
authors.initials: E
authors.lastname: Arenas
authors.affiliation: Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, United Kingdom.
authors.forename: Ariel
authors.initials: A
authors.lastname: Castro
authors.affiliation: Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, United Kingdom.
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000328:Adult; D015331:Cohort Studies; D018568:Crown-Rump Length; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011379:Prognosis; D011673:Pulsatile Flow; D012008:Recurrence; D012306:Risk; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000000981:diagnostic imaging*