Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 13 , ISSUE 4 ( October-December, 2019 ) > List of Articles


Doppler Sonography of Uterine Arteries in Pregnancy as a Marker of Preeclampsia

Admir Rama, Amela Muftic

Keywords : Doppler sonography, Notch, Preeclampsia.

Citation Information : Rama A, Muftic A. Doppler Sonography of Uterine Arteries in Pregnancy as a Marker of Preeclampsia. Donald School J Ultrasound Obstet Gynecol 2019; 13 (4):162-168.

DOI: 10.5005/jp-journals-10009-1611

License: CC BY-NC 4.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2019; The Author(s).


Introduction: Preeclampsia is the cause of increased morbidity in mothers, and mortality and morbidity of both mothers and fetuses and newborns. The pathological process is already complete when the symptoms occur, and nothing concrete can be done to stop the process. Early identification of women at risk of developing preeclampsia is a key goal of antenatal care. Alongside chemical tests, Doppler sonography of the uterine arteries plays a major role in the prediction of preeclampsia. Aims: To establish the probability of resistance to blood flow in the uterine arteries and the existence of notching in the control and test groups. Materials and methods: The study comprised 60 subjects in the second trimester of pregnancy who were going for check-ups during their pregnancy or had been hospitalized at the Maternity Clinic of Sarajevo UCC. All the subjects were divided into two groups, a control and a test group, in relation to the presence of pathological blood flow in the uterine arteries. As well as ultrasound results, the patients also provided an exhaustive history about their previous pregnancies, if any, and any relevant laboratory results. Results: A statistically significant difference was found in the average values of systolic and diastolic pressure during pregnancy between the control and the test group (p = 0.001). From an analysis of the resistance to blood flow in the uterine arteries in the control and test groups, we concluded that the flow on the side with the placenta and on the side without the placenta were physiological over five measurements in the control group of subjects. In the test group the largest number of cases of pathological flow were recorded, and there was also notching. Of the 21 subjects with a diagnosis of preeclampsia, there was notching in 10. Conclusion: Doppler sonography in the second trimester of pregnancy is a good prognostic marker for early discovery of preeclampsia.

  1. Di Lorenzo G, Ceccarello M, Cecotti V, et al. First trimester maternal serum PIGF, free β-hCG, PAPP-A, PP-13, uterine artery Doppler and maternal history for the prediction of preeclampsia. Placenta 2012;33(6):495–501. DOI: 10.1016/j.placenta.2012.03.003.
  2. Hafner T, Kurjak A, Kupešić S. Doplerska mjerenja uteroplacentnog krvotoka. In: Kurjak A, ed. Ultrazvuk u ginekologiji i porodništvu. Zagreb: Art studio Azinović; 2000. pp. 383–385.
  3. Kurjak A, Kupesic S, Hafner T, et al. Conflicting data on intervillous circulation in early pregnancy. J Perinat Med 1997;25(3):225–236. DOI: 10.1515/jpme.1997.25.3.225.
  4. Woschitz MC, Idris T, Csapo B, et al. Uterine artery Doppler in women with history of previous preeclampsia and women with chronic hypertension: re-evaluation of a prognostic value in a high-risk population. Gynecol Obstet (Sunnyvale) 2014;4:206.
  5. Srikumar S, Debnath J, Ravikumar R, et al. Doppler indices of the umbilical and fetal middle cerebral artery at 18-40 weeks of normal gestation: a pilot study. Med J Armed Forces India 2017;73(3):232–241. DOI: 10.1016/j.mjafi.2016.12.008.
  6. Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for preeclampsia: US preventive services task force recommendation statement. JAMA 2017;317(16):1661–1667. DOI: 10.1001/jama.2017.3439.
  7. Kandasamy Y, Watson D, Rudd D. Biomarker of early glomerular injury in pre-eclampsia. Hypertens Pregnancy 2015;34(4):391–399. DOI: 10.3109/10641955.2015.1065883.
  8. Fareeha A, Hidayat U, Mashkoor A. Predictor of pre-eclampsia with uterine artery Doppler. Pak Armed Forces Med J 2016;66(6):886–890.
  9. Sharma S, Singh S, Gujral U, et al. Uterine artery notching on color Doppler ultrasound and roll over test in prediction of pregnancy induced hypertension. J Obstet Gynaecol India 2011;61(6):649–651. DOI: 10.1007/s13224-011-0110-z.
  10. Tranquilli AL, Dekker G, Magee L, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: a revised statement from the ISSHP. Pregnancy Hypertens 2014;4(2):97–104. DOI: 10.1016/j.preghy.2014.02.001.
  11. Henderson JT, Thompson JH, Burda BU, et al. Screening for Preeclampsia: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017. (Evidence Synthesis, No. 148), available from:
  12. Abalos E, Cuesta C, Grosso AL, et al. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol 2013;170(1):1–7. DOI: 10.1016/j.ejogrb.2013.05.005.
  13. Kattah AG, Garovic VD. The management of hypertension in pregnancy. Adv Chronic Kidney Dis 2013;20(3):229–239. DOI: 10.1053/j.ackd.2013.01.014.
  14. Steel SA, Pearce JM, McParland P, et al. Early Doppler ultrasound screening in prediction of hypertensive disorders of pregnancy. Lancet 1990;335(8705):1548–1551. DOI: 10.1016/0140-6736(90)91376-L.
  15. North RA, Ferrier C, Long D, et al. Uterine artery Doppler flow velocity waveforms in the second trimester for the prediction of preeclampsia and fetal growth retardation. Obstet Gynecol 1994;83(3): 378–386.
  16. Albaiges G, Missfelder-Lobos H, Lees C, et al. One-stage screening for pregnancy complications by color Doppler assessment of the uterine arteries at 23 weeks’ gestation. Obstet Gynecol 2000;96(4):559–564. DOI: 10.1016/S0029-7844(00)00946-7.
  17. Yu CK, Khouri O, Onwudiwe N, et al. Prediction of pre-eclampsia by uterine artery Doppler imaging: relationship to gestational age at delivery and small-for-gestational age. Ultrasound Obstet Gynecol 2008;31(3):310–313. DOI: 10.1002/uog.5252.
  18. Bower S, Schuchter K, Campbell S. Doppler ultrasound screening as part of routine antenatal scanning: prediction of preeclampsia and intrauterine growth retardation. Br J Obstet Gynecol 2000;100(11):989–994. DOI: 10.1111/j.1471-0528.1993.tb15139.x.
  19. Conde-Agudelo A, Lede R, Belizan J. Evaluation methods used in the prediction of hypertensive disorders of pregnancy. Obstet Gynecol Surv 2008;49(3):210–222. DOI: 10.1097/00006254-199403000-00027.
  20. Kane SC, Da Silva Costa F, Brennecke SP. New directions in the prediction of pre-eclampsia. Aust N Z J Obstet Gynaecol 2014;54(2):101–107. DOI: 10.1111/ajo.12151.
  21. Plasencia W, Maiz N, Poon L, et al. Uterine artery Doppler at 11 + 0 to 13 + 6 weeks and 21 + 0 to 24 + 6 weeks in the prediction of pre-eclampsia. Ultrasound Obstet Gynecol 2008;32(2):138–146. DOI: 10.1002/uog.5402.
  22. Prajapati SR, Maitra N. Prediction of pre-eclampsia by a combination of maternal history, uterine artery Doppler, and mean arterial pressure (a prospective study of 200 cases). J Obstet Gynaecol India 2013;63(1):32–36. DOI: 10.1007/s13224-012-0239-4.
  23. Jamal A, Abbasalizadeh F, Vafaei H, et al. Multicenter screening for adverse pregnancy outcomes by uterine artery Doppler in the second and third trimester of pregnancy. Med Ultrason 2013;15(2):95–100. DOI: 10.11152/mu.2013.2066.152.aj1fa2.
  24. Pongrojpaw D, Chanthasenanont A, Nanthakomon T. Second trimester uterine artery Doppler screening in prediction of adverse pregnancy outcome in high risk women. J Med Assoc Thai 2010;93(Suppl 7):S127–S130.
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