title: Uterine and umbilical artery Doppler at 28 weeks for predicting adverse pregnancy outcomes in women with abnormal uterine artery Doppler findings in the early second trimester.
abstract: OBJECTIVE
  The objective of this study was to determine the contribution of uterine (UtA) and umbilical arteries (UA) Doppler examination at 28 weeks to predict adverse pregnancy outcomes in women who had increased resistance in UtA in the early second trimester.
  
  
  METHODS
  Women with UtA mean pulsatility index (PI) above the 95th centile at 19-22 weeks of gestation were offered a growth scan including Doppler examination of UtA and UA at 28 weeks. Adverse pregnancy outcomes included small for gestational age (SGA), defined as birth weight below the tenth centile, preeclampsia (PE) and early-onset PE (PE before 34 weeks).
  
  
  RESULTS
  We studied 266 pregnant women with elevated PI in the UtAs in the second trimester and ultrasound reassessment at 28 weeks. UtA PI >95th centile at 28 weeks was associated with subsequent PE [odds ratio (OR): 10.0, 95% CI: 2.3-43.5], early-onset PE (OR: 57.7, 95% CI: 3.8-87.6) and SGA less than the tenth centile (OR: 5.5, 2.2-13.9). UA PI >95th centile at 28 weeks was not significantly associated with any adverse outcome.
  
  
  CONCLUSIONS
  In women with abnormal UtA Doppler in the early second trimester scan, persistence of elevated UtA PI, but not abnormal UA PI, is associated with adverse pregnancy outcomes including PE, early-onset PE and SGA. © 2014 John Wiley & Sons, Ltd.
authors.affiliation: Fetal Medicine Unit, Instituto Nacional Materno Perinatal, Lima, Peru.
authors.forename: Walter
authors.initials: W
authors.lastname: Ventura
authors.forename: Catalina
authors.initials: C
authors.lastname: De Paco Matallana
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Prieto-Sanchez
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Macizo
authors.forename: Miriam
authors.initials: M
authors.lastname: Pertegal
authors.forename: Aníbal
authors.initials: A
authors.lastname: Nieto
authors.forename: Juan L
authors.initials: JL
authors.lastname: Delgado
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011262:Pregnancy Trimester, Second; D011673:Pulsatile Flow; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D055988:Uterine Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014655:Vascular Resistance