ABSTRACT
OBJECTIVE: To assess the value of uterine artery Doppler as a screening test for preeclampsia and/or having a small-for-gestational-age (SGA) infant in healthy pregnant women. METHODS: Color Doppler ultrasound was used to examine both uterine arteries in 400 healthy pregnant women at 24.8 +/- 2.0 (range, 22 to 28) weeks of gestation. The mean pulsatility index of both uterine arteries was calculated and the presence of an early diastolic notch in the waveform was noted. RESULTS: Twenty-six (6.5%) of the 400 women developed preeclampsia and/or had an SGA infant. The optimal cutoff value for the mean pulsatility index in predicting preeclampsia and/or having an SGA infant was 0.857. When using a high mean pulsatility index and/or the presence of any early diastolic notch, the detection of preeclampsia and/or having SGA infant were a sensitivity of 76.9%, a specificity of 52.9%, a positive predictive value of 10.2%, and a negative predictive value of 97.1%, respectively. CONCLUSION: Women with an abnormal uterine artery Doppler great a considerably higher risk for developing preeclampsia and/or having an SGA infant.
Subject(s)
Fetal Growth Retardation/diagnosis , Pre-Eclampsia/diagnosis , Pulsatile Flow , Ultrasonography, Doppler, Color , Uterus/blood supply , Female , Humans , Infant, Newborn , Infant, Small for Gestational Age , Mass Screening , Pregnancy , Pregnancy Outcome , Prospective Studies , Uterus/diagnostic imagingABSTRACT
The objective was to assess the value of uterine artery notching as a screening test for preeclampsia and fetal growth restriction in a low-risk population of healthy pregnant women. Color Doppler ultrasound was used to examine both uterine arteries in 322 healthy pregnant women at 24.9 +/- 1.9 (range 22-28) weeks of gestation. The criterion for abnormal results was a unilateral or bilateral presence of an early diastolic notch. The major end points were preeclampsia and small for gestational age (SGA) infants. Of the 322 women, 19 (5.9%) developed preeclampsia and six of them (1.9%) delivered SGA infants. An early diastolic notch was detected in 58 women (18%). The risk of developing preeclampsia and SGA infants in an abnormal Doppler study group was found to be greater than in that of a normal group (P<0.05). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detecting preeclampsia were 36.8, 83.2, 12.1, and 95.5%, respectively; whereas detecting SGA infants were 67, 82.9, 6.9, and 99.2%, respectively. Women with an early diastolic notch have considerably a higher risk of developing preeclampsia and SGA infants. On the other hand, women with normal uterine artery waveforms are unlikely to develop preeclampsia and SGA infants. The test may be useful to minimize unnecessary interventions.
Subject(s)
Arteries/physiology , Fetal Growth Retardation/diagnostic imaging , Pre-Eclampsia/diagnostic imaging , Ultrasonography, Prenatal/standards , Uterus/blood supply , Adult , Female , Fetal Growth Retardation/physiopathology , Humans , Infant, Newborn , Infant, Small for Gestational Age , Pre-Eclampsia/physiopathology , Predictive Value of Tests , Pregnancy , Pregnancy Outcome , Pulsatile Flow , Regional Blood Flow , Sensitivity and Specificity , Ultrasonography, DopplerABSTRACT
Color pulsed Doppler ultrasound was used to examine the uterine arteries of a total of 265 normal pregnant women during 22-28 weeks' gestation at the Division of Maternal-Fetal Medicine, King Chulalongkorn Memorial Hospital. Reference ranges for pulsatility index (PI) were determined and throughout this gestational range, the mean values were nearly constant and lower than 0.9 and the upper limit of 95 per cent confidence interval (CI) for the PI values were lower than 1.0. In conclusion, the authors have established the reference ranges for PI of uterine arteries in the late second to early third trimester of pregnancy in Thai pregnant women. This could be beneficial for the baseline data in the evaluation of pregnant women complicated with preeclampsia and fetal growth restriction.
