Predictive value of sequential models of uterine artery Doppler in pregnancies at high risk for pre-eclampsia

Background: Preeclampsia is a multisystem disorder which affects about 2% of pregnancies and represents a major threat to mother and foetus when it emerges. In some women this condition sets in a subtle way and gradually such women develop severe degree of preeclampsia leading to dreadful complications. Uterine artery doppler velocimetry is a non-invasive method to examine the uteroplacental circulation that provides indirect evidence of blood ow and is proposed a predictive test for preeclampsia. This prospective observational study was performed to assess the usefulness of uterine artery Doppler in predicting preeclampsia. Methods: 50 high risk and 50 low risk singleton pregnancies between 16-28 weeks of gestational age with uterine artery doppler study were followed up till delivery or development of preeclampsia to determine maternal and fetal outcome. Results: Sensitivity and specicity of abnormal uterine artery doppler study for prediction of preeclampsia were 90 % and 70 % in high-risk and 42 % and 90 % in low-risk group, respectively. Positive predictive value and negative predictive value was 92 % and 63 % in high risk group and 42 % and 90 % in low risk group respectively. Conclusions: Mid trimester doppler velocimetry of uterine artery can be used as a reliable screening test for prediction of preeclampsia in both high-risk and low-risk women.

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Significance of obstetric Doppler studies in prediction of perinatal outcome in pregnancy induced hypertension

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172312 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2354 ◽

Cited By ~ 1

Author(s):

Pradip R. Gaikwad ◽

Manisha R. Gandhewar ◽

Nity Rose ◽

Vidyadhar Suryakar

Keyword(s):

Diagnostic Accuracy ◽

Doppler Ultrasound ◽

Predictive Value ◽

Perinatal Outcome ◽

Uterine Artery ◽

Pregnancy Induced Hypertension ◽

Doppler Studies ◽

Uterine Artery Doppler ◽

Adverse Perinatal Outcome ◽

Induced Hypertension

Background: Pregnancy induced hypertension (PIH) is associated with adverse perinatal outcome. Multi vessel color Doppler studies are useful in these cases for timely intervention. The aim of present study was to know the significance of umbilical, middle cerebral and uterine artery Doppler studies in PIH and to analyse its role in predicting perinatal outcome.Methods: This was a prospective study of 106 singleton pregnancies in the third trimester with PIH. The results of last Doppler ultrasound within one week of delivery were used for analysis. Adverse perinatal outcome was studied in the form of emergency cesarean section for fetal distress, meconium stained amniotic fluid, Apgar at 5 min <7, NICU admission and perinatal mortality (stillbirths and neonatal death). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of various Doppler parameters were calculated after comparing with standard.Results: In the present study specificity and diagnostic accuracy of all Doppler ultrasound parameters was high in predicting adverse perinatal outcome. Cerebroplacental ratio showed highest specificity (98.55%), PPV (94.44%) and diagnostic accuracy (80.19%) in predicting adverse perinatal outcome and it is better than MCA PI and UA PI alone. Uterine artery Doppler evaluation also gives additional information in predicting adverse perinatal outcome.Conclusions: Amongst various Doppler parameters cerebroplacental index (MCA/UA PI) is best predictor of adverse perinatal outcome.

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Maternal cardiolipin, β2 -glycoprotein-I and prothrombin antibody expression in high-risk pregnancies with bilateral abnormal uterine artery Doppler waveforms

Ultrasound in Obstetrics and Gynecology ◽

10.1046/j.1469-0705.1999.13050317.x ◽

1999 ◽

Vol 13 (5) ◽

pp. 317-322 ◽

Cited By ~ 2

Author(s):

S. Donohoe ◽

M. Geary ◽

J. C. P. Kingdom ◽

E. Jauniaux ◽

G. Purdy ◽

...

Keyword(s):

High Risk ◽

Uterine Artery ◽

Uterine Artery Doppler ◽

Antibody Expression ◽

Glycoprotein I

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Prediction of preeclampsia using a combination of serum micro RNA-210 and uterine artery Doppler ultrasound

Science Progress ◽

10.1177/00368504211036856 ◽

2021 ◽

Vol 104 (3) ◽

pp. 003685042110368

Author(s):

Ananya Trongpisutsak ◽

Vorapong Phupong

Keyword(s):

Pregnant Women ◽

Doppler Ultrasound ◽

Predictive Value ◽

Early Onset ◽

Uterine Artery ◽

Micro Rna ◽

Predictive Values ◽

Uterine Artery Doppler ◽

Early Onset Preeclampsia ◽

Sensitivity Specificity

The objective was to determine whether a combination of serum micro RNA-210 level and uterine artery Doppler can predict preeclampsia in pregnant women at 16–24 weeks gestation. A prospective observational study conducted in singleton pregnant women at 16–24 weeks of gestation who had prenatal care at the King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand between 2017 and 2018. Uterine artery Doppler ultrasound and blood testing for serum micro RNA-210 were performed. Pregnancy outcomes were recorded. Optimal cut-off for uterine artery pulsatility index (PI) and serum micro RNA-210 were obtained to calculate the predictive values for preeclampsia. Data from 443 participants were analyzed. Twenty-two cases developed preeclampsia (5.0%) and seven of these preeclamptic cases had early-onset preeclampsia (1.6%). Pregnant women with preeclampsia had higher mean PI of the uterine artery (1.34 ± 0.52 vs 0.98 ± 0.28, p = 0.004), higher detection rates of diastolic notching (45.5% vs 11.2%, p < 0.001), and lower median serum micro RNA-210 level (22.86 vs 795.78, p < 0.001) than pregnant women without preeclampsia. Using abnormal serum micro RNA-210 level, abnormal mean PI or uterine artery diastolic notches to predict for preeclampsia, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 95.5%, 54.9%, 10.0%, and 99.6%, respectively. For early-onset preeclampsia prediction, the sensitivity, specificity, PPV, and NPV were 100.0%, 53.2%, 3.3%, and 100.0%, respectively. This study demonstrated that a combination of serum micro RNA-210 and uterine artery Doppler is effective in predicting preeclampsia in the second trimester.

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Role of second trimester uterine artery doppler for the prediction of preeclampsia in high risk pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190855 ◽

2019 ◽

Vol 8 (3) ◽

pp. 906

Author(s):

Madhuri Thakur ◽

Reeti Mehra

Keyword(s):

Risk Factors ◽

High Risk ◽

Uterine Artery ◽

High Risk Pregnancy ◽

Second Trimester ◽

Uterine Artery Doppler ◽

Risk Pregnancy ◽

Doppler Study ◽

Doppler Indices

Background: The uterine artery Doppler has potentials for screening for complications of impaired placentation. The purpose of study was to assess the role of uterine artery color Doppler waveform analysis in second trimester for the prediction of preeclampsia in a high-risk pregnancy between 18-24 weeks of gestation.Methods: 100 women with moderate or high-risk factors for developing preeclampsia reporting to Obstetrics and Gynaecology department of Government Medical College and Hospital, Sector 32, Chandigarh were enrolled for present study. Transabdominal uterine artery doppler measurements was done at 18-24weeks of gestation in these patients. Doppler . The Doppler indices generated automatically from the machine , the Pulsatility Index (PI), Resistance Index (RI) , presence or absence of diastolic notch and S/D Ratio were recorded, and average was calculated.Results: Out of 100 patients there were 46 primigravidas with no additional risk factors, 22 pateints with two or more risk factors and there were no patients who had three or more risk factors in present study population. Preeclampsia is seen more commonly in primigravida and primigravida is considered as moderate risk factor for preeclampsia. It was found that an elevated second trimester uterine artery RI was significantly associated with developing preeclampsia later in pregnancy. The sensitivity and specificity of uterine artery Doppler velocimetry were found to be 84% and 55% respectively. Receiver operator characteristics (ROC) curves were created to demonstrate the prognostic value of RI and PI of uterine artery doppler indices at 18-24 weeks of gestation for the development preeclampsia. In addition, there were statistically significant positive correlations between mean RI of uterine artery doppler study and patients who developed preeclampsia. With a sensitivity of 84.21% it could identify 31% of the cases of preeclampsia at a false positive rate of 44.4%.Conclusions: Uterine artery doppler study can be used as a predictor of moderate strength for preeclampsia.

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