title: First-trimester uterine artery Doppler analysis in the prediction of later pregnancy complications.
abstract: Uterine artery Doppler waveform analysis has been extensively studied in the second trimester of pregnancy as a predictive marker for the later development of preeclampsia and fetal growth restriction. The use of Doppler interrogation of this vessel in the first trimester has gained momentum in recent years. Various measurement techniques and impedance indices have been used to evaluate the relationship between uterine artery Doppler velocimetry and adverse pregnancy outcomes. Overall, first-trimester Doppler interrogation of the uterine artery performs better in the prediction of early-onset than late-onset preeclampsia. As an isolated marker of future disease, its sensitivity in predicting preeclampsia and fetal growth restriction in low risk pregnant women is moderate, at 40-70%. Multiparametric predictive models, combining first-trimester uterine artery pulsatility index with maternal characteristics and biochemical markers, can achieve a detection rate for early-onset preeclampsia of over 90%. The ideal combination of these tests and validation of them in various patient populations will be the focus of future research.
authors.affiliation: Department of Perinatal Medicine, Royal Women's Hospital, Melbourne, VIC 3052, Australia ; Pauline Gandel Women's Imaging Centre, Royal Women's Hospital, Melbourne, VIC 3052, Australia.
authors.forename: Su Lynn
authors.initials: SL
authors.lastname: Khong
authors.affiliation: Department of Perinatal Medicine, Royal Women's Hospital, Melbourne, VIC 3052, Australia ; Pauline Gandel Women's Imaging Centre, Royal Women's Hospital, Melbourne, VIC 3052, Australia ; Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, VIC 3010, Australia, Australia.
authors.forename: Stefan C
authors.initials: SC
authors.lastname: Kane
authors.affiliation: Department of Perinatal Medicine, Royal Women's Hospital, Melbourne, VIC 3052, Australia ; Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, VIC 3010, Australia, Australia.
authors.forename: Shaun P
authors.initials: SP
authors.lastname: Brennecke
authors.affiliation: Department of Perinatal Medicine, Royal Women's Hospital, Melbourne, VIC 3052, Australia ; Pauline Gandel Women's Imaging Centre, Royal Women's Hospital, Melbourne, VIC 3052, Australia ; Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, VIC 3010, Australia, Australia ; Monash Ultrasound for Women, Clayton, VIC 3168, Australia.
authors.forename: Fabrício
authors.initials: F
authors.lastname: da Silva Costa
mesh_terms: D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000502:physiology; D011673:Pulsatile Flow; D055988:Uterine Artery / Q000502:physiology*