title: Uterine artery Doppler in high-risk pregnancies at 23-24 gestational weeks is of value in predicting adverse outcome of pregnancy and selecting cases for more intense surveillance.
abstract: OBJECTIVE
  To assess the role of the placental arterial Doppler examination at 23-24 gestational weeks for predicting adverse perinatal outcome in high-risk pregnancies.
  
  
  METHODS
  Retrospective register study.
  
  
  METHODS
  Skåne University Hospital in Malmö.
  
  
  METHODS
  Six hundred and forty-five women with high-risk pregnancies, without fetal malformations or chromosomal abnormalities.
  
  
  METHODS
  Placental (uterine and umbilical artery) Doppler ultrasound examination at 23-24 gestational weeks.
  
  
  METHODS
  Adverse perinatal outcomes including preeclampsia, small-for-gestational age newborns (smaller than 3rd percentile or smaller than the 10th percentile), preterm delivery (<34 weeks or <37 weeks of gestation at delivery), cesarean section, admission to the neonatal intensive care unit and intra-uterine fetal death.
  
  
  RESULTS
  Abnormal uterine artery Doppler values were detected in 45% of this high-risk group but abnormal umbilical artery Doppler indices were only seen in 3.7%. Adverse perinatal outcome increased significantly with increasing placental vascular impedance (p < 0.0001). There were seven cases of intrauterine fetal death and in five the uterine artery Doppler values at 23-24 weeks were abnormal. A strong correlation between abnormal uterine artery Doppler and preeclampsia was present, but not with other forms of hypertensive disorder.
  
  
  CONCLUSIONS
  Placental Doppler screening at 23-24 weeks can be used in detecting pregnancies at risk of adverse outcome and in selecting cases for more intense surveillance. A surveillance plan is proposed based on Doppler screening at 23-24 weeks of gestation.
authors.affiliation: Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, Shenyang, China.
authors.forename: Na
authors.initials: N
authors.lastname: Li
authors.forename: Gisela
authors.initials: G
authors.lastname: Ghosh
authors.forename: Saemundur
authors.initials: S
authors.lastname: Gudmundsson
mesh_terms: D000328:Adult; D005260:Female; D005313:Fetal Death; D006801:Humans; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012039:Regional Blood Flow; D012042:Registries; D012189:Retrospective Studies; D013548:Sweden; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D016216:Ultrasonography, Prenatal / Q000379:methods; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Doppler; intra-uterine growth restriction; perinatal outcome; placenta; preeclampsia; pregnancy; ultrasound; umbilical artery; uterine artery