title: Association between first trimester vaginal bleeding and uterine artery Doppler measured at second and third trimesters of pregnancy.
abstract: OBJECTIVE
  To evaluate the prevalence of first trimester vaginal bleeding among patients with abnormal second and third trimester uterine artery Doppler.
  
  
  METHODS
  A prospective study of patients with a uterine artery Doppler measurement between 27 and 42 weeks' gestation was undertaken. A comparison was made between two groups: patients with and without first trimester vaginal bleeding. Abnormal uterine artery Doppler was defined as PI >95th% or the presence of a diastolic notch.
  
  
  RESULTS
  Of the 277 patients that were included in the study, 65 (23%) had first trimester vaginal bleeding. No differences were noted in uterine artery Doppler waveforms among patients with and without first trimester vaginal bleeding. Among patients with first trimester vaginal bleeding, 9 (14%) had a bilateral uterine artery notch and 56 (86%) did not, compared with 51 (24%) and 161 (76%), in the control group, respectively. Patients with first trimester vaginal bleeding, and a bilateral uterine artery notch had significantly higher rates of small for gestational age neonates, low-Apgar scores (<7) at one minute and cesarean deliveries compared to patients with first trimester vaginal bleeding who did not have bilateral uterine artery notch.
  
  
  CONCLUSIONS
  First trimester vaginal bleeding was not associated with a higher incidence of abnormal uterine artery waveforms or with placental related conditions. However, adverse perinatal outcomes were found when first trimester vaginal bleeding was associated with second and third trimester bilateral uterine artery notchs.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences , Ben-Gurion University of the Negev , Israel and.
authors.forename: Gali
authors.initials: G
authors.lastname: Pariente
authors.forename: Paulina
authors.initials: P
authors.lastname: Shwarzman
authors.forename: Barak
authors.initials: B
authors.lastname: Aricha-Tamir
authors.forename: Adi Y
authors.initials: AY
authors.lastname: Weintraub
authors.forename: Reli
authors.initials: R
authors.lastname: Hershkovitz
mesh_terms: D001783:Blood Flow Velocity; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D011256:Pregnancy Outcome / Q000453:epidemiology; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal / Q000379:methods; D055988:Uterine Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology