Risk assessment of preeclampsia in advanced maternal age by uterine arteries Doppler at 17-21 weeks of gestation.

ABSTRACT

OBJECTIVE: To assess the risk of preeclampsia development in elderly gravidarum by uterine arteries Doppler at 17-21 weeks' gestation. MATERIAL AND METHOD: Pulsatility index (PI) of the uterine arteries was measured by color Doppler transabdominal sonography in 298 elderly gravida women at 17-21 weeks of gestation. The criterion for abnormal results was PI > 95th percentile of each gestational age and/or the presence of bilateral notches. The major end point was preeclampsia. RESULTS: Ten woman (3.4%) developed preeclampsia. Two hundred and eighty-four women (95.3%) had a normal Doppler flow of uterine arteries (PI < or =95th percentile of each gestational age), and 14 woman (4.7%) had abnormal Doppler flow of uterine arteries. The sensitivity, specificity, and positive and negative predictive values for detecting preeclampsia were 20%, 95.8%, 14.3%, and 97.2%, respectively. CONCLUSION: Women with mean PI > 95th of each gestational age have a high risk of developing preeclampsia. With the high negative predictive value, this test may be useful to minimize unnecessary interventions.