ABSTRACT
To assess the relationship between first trimester uterine artery Doppler measurements and the development of term and preterm pre-eclampsia. This prospective study of uterine artery Doppler findings at 11-14 weeks in 3058 singleton pregnancies, included 57 and 33 cases of term and preterm preeclampsia, respectively. The first-trimester uterine artery resistance index [RI] was significantly higher in women who subsequently developed preterm pre-eclampsia [mean RI, 0.79] than in those with a normal outcome [mean RI, 0.70; p=0.0001] or those who developed pre-eclampsia at term [mean RI, 0.72; p=0.002]. There were no significant differences in first-trimester mean uterine artery RI [p=0.136] or prevalence of bilateral notches [p=0.459] between women who had a normal pregnancy outcome and those who developed pre-eclampsia at term. The receiver-operating characteristics curves for the prediction of term and preterm pre-eclampsia by uterine artery Doppler imaging demonstrated a significant association with development of preterm pre-eclampsia [p=0.0001; area under the curve [AUC], 0.76; 95% CI, 0.66-0.86] but not term pre-eclampsia [p=0.25; AUC, 0.54; 95% CI, 0.46-0.63]. The uterine artery Doppler data in this study suggest that preterm pre-eclampsia is strongly associated with defective invasion of the spiral arteries, in contrast to the findings in term pre-eclampsia which may be a consequence of placental deterioration at term. We support separation between the etiology of early- and late-onset pre-eclampsia, there is a strong relationship between first-trimester uterine artery Doppler indices and the subsequent development of preterm pre-eclampsia