title: Uterine artery Doppler in the management of early pregnancy loss: a prospective, longitudinal study.
abstract: BACKGROUND
  The pharmacological management of early pregnancy loss reduced substantially the need for dilation and curettage. However, prognostic markers of successful outcome were not established. Thus the major purpose of this study was to determine the sensitivity and specificity of the uterine artery pulsatility (PI) and resistance (RI) indices to detect early pregnancy loss patients requiring dilation and curettage after unsuccessful management.
  
  
  METHODS
  A cohort prospective observational study was undertaken to include women with early pregnancy loss, ≤ 12 weeks of gestation, managed with mifepristone (200 mg) and misoprostol (1600 μg) followed by PI and RI evaluation of both uterine arteries 2 weeks after. At this time, in 173/315 patients, incomplete miscarriage was diagnosed. Among them, 32 underwent uterine dilatation and curettage at 8 weeks of follow-up.
  
  
  RESULTS
  The cut-off points for the uterine artery PI and RI, leading to the maximum values of sensitivity (69.5%, CI95%: 61.5%-76.5% and 75.0%, CI95%: 57.9%-86.8%, respectively) and specificity (75.0%, CI95%: 57.9%-86.8% and 65.6%, CI95%: 48.3%-79.6%, respectively), for the discrimination between the women who needed curettage from those who resolved spontaneously were 2.8 and 1, respectively.
  
  
  CONCLUSIONS
  The potential usefulness of uterine artery Doppler evaluation to predict the need for uterine curettage in patients submitted to medical treatment for early pregnancy loss was demonstrated.
authors: Department of Experimental Biology, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal. luis.guedes.martins@gmail.com.|Hospital Centre of Porto EPE, Department of Women and Reproductive Medicine, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. luis.guedes.martins@gmail.com.
authors: Luís
authors: L
authors: Guedes-Martins
authors: Hospital Centre of Porto EPE, Department of Women and Reproductive Medicine, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. saraivajp@hotmail.com.|Obstetrics-Gynecology, Private Hospital Trofa, 4785-409, Trofa, Portugal. saraivajp@hotmail.com.
authors: Joaquim P
authors: JP
authors: Saraiva
authors: Department of Mathematics, Faculty of Sciences, University of Porto, 4169-007, Porto, Portugal. argaio@fc.up.pt.|CMUP-Centre of Mathematics, University of Porto, 4169-007, Porto, Portugal. argaio@fc.up.pt.
authors: Ana R
authors: AR
authors: Gaio
authors: Centro de Simulação Médica do Porto (CESIMED), 4465-024, São Mamede de Infesta, Portugal. reynolds@cesimed.pt.
authors: Ana
authors: A
authors: Reynolds
authors: Department of Medicine, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal. filipe.macedo@hsjoao.min-saude.pt.|Department of Cardiology, S. João Hospital Centre, 4200-319, Porto, Portugal. filipe.macedo@hsjoao.min-saude.pt.
authors: Filipe
authors: F
authors: Macedo
authors: Department of Experimental Biology, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal. almeidah@med.up.pt.|Obstetrics-Gynecology, CUF-Hospital Porto, 4100 180, Porto, Portugal. almeidah@med.up.pt.
authors: Henrique
authors: H
authors: Almeida
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D000021:Abortifacient Agents, Steroidal / Q000627:therapeutic use; D000027:Abortion, Incomplete / Q000000981:diagnostic imaging* / Q000628:therapy; D000022:Abortion, Spontaneous / Q000000981:diagnostic imaging* / Q000628:therapy; D000328:Adult; D015331:Cohort Studies; D004107:Dilatation and Curettage / Q000706:statistics & numerical data; D019468:Disease Management; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015735:Mifepristone / Q000627:therapeutic use; D016595:Misoprostol / Q000627:therapeutic use; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011379:Prognosis; D011446:Prospective Studies; D011673:Pulsatile Flow; D018608:Ultrasonography, Doppler; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D014655:Vascular Resistance; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone