Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

VOLUME 4 , ISSUE 2 ( April-June, 2010 ) > List of Articles

REVIEW ARTICLE

Uterine Artery Doppler in the Prediction of Preeclampsia and Adverse Pregnancy Outcome

George Daskalakis, Aris Antsaklis

Keywords : Preeclampsia,screening,ultrasound,uterine artery Doppler

Citation Information : Daskalakis G, Antsaklis A. Uterine Artery Doppler in the Prediction of Preeclampsia and Adverse Pregnancy Outcome. Donald School J Ultrasound Obstet Gynecol 2010; 4 (2):117-122.

DOI: 10.5005/jp-journals-10009-1134

License: CC BY-NC 4.0

Published Online: 00-06-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Preeclampsia and fetal growth restriction are major causes of perinatal mortality and morbidity. Several studies have shown that a generalized endothelial dysfunction is associated with these complications. Clinical trials have shown that pregnant women who demonstrate high resistance in uteroplacental blood flow are at higher risk for preeclampsia. Uterine artery Doppler studies both in the second and the first trimester can predict pregnancies at increased risk of the complications of impaired placentation. The sensitivity for predicting severe preeclampsia ranges between 80 and 90% for a false positive rate of 5 to 7%. Uterine artery Doppler screening at 20 to 24 weeks’ gestation is superior to first trimester screening, and appears to fulfill the requirements for a worthwhile screening test. Further research is needed to better assess the value of various combinations of uterine artery Doppler and maternal serum markers, for the prediction of adverse pregnancy outcome.


PDF Share
  1. Epidemiology of fetal death in Latin America. Acta Obstet Gynecol Scand 2000;79:371-78.
  2. Eclampsia and preeclampsia: A worldwide health problem for 2000 years. In: Critchley H, MacLean A, Poston L, Walker J (Eds). Preeclampsia. London: RCOG Press; 2003;189-207.
  3. The placental problem: Linking abnormal cytotrophoblast differentiation to the maternal symptoms of preeclampsia. Reprod Biol Endocrinol 2004;2:53-57.
  4. A comprehensive study of oxidative stress and antioxidant status in preeclampsia and normal pregnancy. Free Radic Biol Med 2004;37:557-70.
  5. The physiological response of the vessels of the placental bed to normal pregnancy. Journal of Pathology and Bacteriology 1967;93:569-79.
  6. Pathogenesis and genetics of preeclampsia (review). Lancet 2001;357:53-56.
  7. Uteroplacental circulation development: Doppler assessment and clinical importance. Placenta 2001;22:795-99.
  8. Fetal and uteroplacental blood flow. Clinical Obstetrics and Gynaecology 1983; 10:565-602.
  9. A classification of hypertension in pregnancy based on Doppler velocimetry. Am J Obstet Gynecol 1987;157:680-85.
  10. Uteroplacental blood flow velocity–time waveforms in normal and complicated pregnancy. Br J Obstet Gynaecol 1985;92:39-45.
  11. Wolrd Health Organization systematic Review of Screening Test for Preeclampsia. Am J Obstet Gynec 2004;104:1367-91.
  12. The role of uterine artery Doppler in predicting adverse pregnancy outcome. Best Pract Res Clin Obstet Gyn 2004;18(3):383-96.
  13. Early Doppler ultrasound screening in prediction of hypertensive disorders of pregnancy. Lancet 1990;335:1548-51.
  14. Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation. Ultrasound Obstet Gynecol 2001;18:441-49.
  15. Doppler ultrasound of the uterine arteries: The importance of bilateral notching in the prediction of pre-eclampsia, placental abruption or delivery of a small-for gestational-age baby. Ultrasound Obstet Gynecol 1996;7:182-88.
  16. One-stage screening for pregnancy complications by color Doppler assessment of the uterine arteries at 23 weeks’ gestation. Obstet Gynecol 2000;96:559-64.
  17. Comparison between three-dimensional placental volume at 12 weeks and uterine artery impedance/notching at 22 weeks in screening for pregnancy-induced hypertension, pre-eclampsia and fetal growth restriction in a low-risk population. Ultrasound Obstet Gynecol 2006;27:652-57.
  18. Usefulness of a placental profile in high-risk pregnancies. Am J Obstet Gynecol 2007;363: e1-e7.
  19. Assessment of risk for the development of pre-eclampsia by maternal characteristics and uterine artery Doppler. BJOG 2005; 112(6):703-09.
  20. Fetal Medicine Foundation Second Trimester Screening Group. An integrated model for the prediction of preeclampsia using maternal factors and uterine artery Doppler velocimetry in unselected low-risk women. Am J Obstet Gynecol 2005;193:429-36.
  21. Early uterine artery Doppler velocimetry and the outcome of pregnancy in women aged 35 years and older. Ultrasound Obstet Gynecol 1995;5:328-33.
  22. Screening for preeclampsia and fetal growth restriction by uterine artery Doppler at 11-14 weeks of gestation. Ultrasound Obstet Gynecol 2001;18: 583-86.
  23. Uterine artery Doppler at 11-14 weeks of gestation to screen for hypertensive disorders and associated complications in an unselected population. Ultrasound Obstet Gynecol 2005;26:490-94.
  24. Screening for preeclampsia and fetal growth restriction by uterine artery Doppler and PAPP-A at 11-14 weeks’ gestation. Ultrasound Obstet Gynecol 2007;29:135-40.
  25. Uterine artery Doppler at 11 + 0 to 13 + 6 weeks in the prediction of pre-eclampsia. Ultrasound Obstet Gynecol 2007;30:742-49.
  26. First-trimester Doppler investigation of the uterine circulation. Am J Obstet Gynecol 2006;195:1210-18.
  27. Maternal cardiac function and uterine artery Doppler at 11-14 weeks in the prediction of pre-eclampsia in nulliparous women. BJOG 2008;115:369-76.
  28. First trimester uterine Doppler and three-dimensional ultrasound placental volume calculation in predicting pre-eclampsia. Eur J Obstet Gynecol Repr Biol 2008;138:147-51.
  29. Improved early prediction of pre-eclampsia by combining second trimester maternal serum inhibin-A and uterine artery Doppler. Ultrasound Obstet Gynecol 2001;17:477-84.
  30. A longitudinal study of biochemical variables in women at risk of preeclampsia. Am J Obstet Gynecol 2002;187:127-36.
  31. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med 2004; 350:672-83.
  32. First trimester placental growth factor and soluble fms-like tyrosine kinase 1 and risk for preeclampsia. J Clin Endocrinol Metab 2004;89:770-75.
  33. Screening test for preeclampsia through assessment of uteroplacental blood flow and biochemical markers of oxidative stress and endotheliam dysfunction. Am J Obstet Gynecol 2005;193:1486-91.
  34. Factor II:C activity and uterine artery Doppler evaluation to improve the early prediction of pre-eclampsia on women with gestational hypertension. J Hypertens 2005;23:141-46.
  35. Screening for preeclampsia by using maternal serum inhibin A, activin A, human chorionic gonadotropin, unconjugated estriol, and alpha-fetoprotein levels and uterine artery Doppler in the second trimester of pregnancy. Aust NZJ Obstet Gynaecol. 2005;45:283-88.
  36. Prediction of preeclampsia by uterine artery Doppler ultrasonography and maternal serum pregnancy-associated plasma protein-A, free beta-human chorionic gonadotropin, activin A and inhibin A at 22+0 to 24+6 weeks’ gestation. Ultrasound Obstet Gynecol 2006;27:658-63.
  37. Identification of patients at risk for early onset and/or severe preeclampsia with the use of uterine artery Doppler velocimetry and placental growth factor. Am J Obstet Gynecol 2007;196:326.e1-13.
  38. Decreased first trimester PAPP-A is a predictor of adverse pregnancy outcome. Prenat Diagn 2002;22:778-82.
  39. First-trimester maternal serum PP-13, PAPP-A and second-trimester uterine artery Doppler pulsatility index as markers of pre-eclampsia. Ultrasound Obstet Gynecol 2007;29:128-34.
  40. A novel approach to first-trimester screening for early pre-eclampsia combining serum PP-13 and Doppler ultrasound. Ultrasound Obstet Gynecol Jan 2006;27:13-17.
  41. Screening for pre-eclampsia by oxidative stress markers and uteroplacental blood flow. J Obstet Gynecol 2008;28:285-89.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.