Role of Uterine Artery Doppler in 11-14 Weeks Scan as a Predictor of Preeclampsia

ABSTRACT

Background: Preeclampsia (PE) is a disease in pregnancy involving interplay of multiple genetic, immunologic and environmental factors. The primary pathology of PE is related to abnormal placentation. Uterine artery doppler in the first trimester is a promising screening test for prediction of PE. Objective: To study the role of first trimester uterine artery doppler in prediction of preeclampsia. Methods: A prospective study was carried out to evaluate the role of uterine artery doppler in the 11- 14 week scan for prediction of preeclampsia and associated IUGR. A total number of 200 women who met our selection criteria were included in the study. Uterine artery doppler was done as part of the 11-14 weeks scan and mean uterine artery PI was calculated. Results: Among the women in the study, PE was detected in 21 women with incidence of 11 %. The sensitivity, specificity, positive predictive value and negative predictive values of mean uterine artery PI for development of PI were 76%, 86%, 39% and 96% respectively. Conclusions: Early identification of pregnancies at high-risk of early onset PE and undertaking the necessary measures to improve placentation can reduce the burden of the disease by using prophylactic aspirin. Effective screening for early onset PE can be achieved in the first-trimester of pregnancy with maternal history, uterine artery doppler and biochemical markers. Biochemical screening for preeclampsia needs to become cheaper and easily accessible for better prediction of PE in first trimester.