Imaging in Gestational Trophoblastic Disease and Implication of Uterine Artery Doppler Study

Background: Pre-eclampsia affects 2-5% of pregnancies and is a major cause of perinatal and maternal morbidity and mortality. Doppler is a non-invasive method for evaluation of feto-placental circulation without affecting pregnancy. A high resistance index in uterine artery Doppler waveform has been shown to be the best non-invasive screening test. Thus, we have conducted this study to find out the predictive value of transvaginal uterine artery doppler in early pregnancy for the prediction of pre-eclampsia. The aim of the study was early prediction of pre-eclampsia by trans-vaginal uterine artery Doppler study at 12-16 weeks.Methods: According to the study criteria 100 antenatal women between 12 to 16 weeks of singleton pregnancy attending out patient in the Department of OBG of S. D. M. Medical College Dharwad were included. After an informed consent, the women underwent ultrasound for dating and subsequently trans-vaginal ultrasound along with color doppler was performed to obtain uterine artery indices. These women were again rescanned at 24-26 weeks of gestation trans-abdominally and further followed up clinically for development of preeclampsia.Results: Out of 100 women, 22 patients developed preeclampsia. At 12-16 weeks 35% of women had bilateral uterine artery notching, mean RI was 0.57 and PI was 0.89. When uterine artery notch at 12-16 weeks alone was considered, 34.28% of women developed preeclampsia. Detection rate increased to 85.71% when RI>0.65 was also included along with notching. Uterine artery notching at 12-16 weeks gestation had 34.29% sensitivity, 84.62% specificity, 70.51% NPV. When notch and RI>0.65 considered together sensitivity and NPV increases to 85.71% to 98.25%.Conclusions: The uterine artery Doppler waveform indices at 12-16 weeks are the best non-invasive screening test available for early prediction of preeclampsia.

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Prediction of Smallness for Gestational Age by Maternal Serum Human Chorionic Gonadotropin Levels and by Uterine Artery Doppler Study

Fetal Diagnosis and Therapy ◽

10.1159/000053879 ◽

2000 ◽

Vol 16 (1) ◽

pp. 42-46 ◽

Cited By ~ 7

Author(s):

Kei Miyakoshi ◽

Mamoru Tanaka ◽

Danilo Gabionza ◽

Hitoshi Ishimoto ◽

Toyohiko Miyazaki ◽

...

Keyword(s):

Chorionic Gonadotropin ◽

Gestational Age ◽

Human Chorionic Gonadotropin ◽

Uterine Artery ◽

Maternal Serum ◽

Uterine Artery Doppler ◽

Doppler Study

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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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Role of uterine artery doppler at 18-22 weeks in the prediction of pre-eclampsia: a prospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204300 ◽

2020 ◽

Vol 9 (10) ◽

pp. 4130

Author(s):

Lakshmi Manjeera M. ◽

Patricia Malini Pereira

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Pulsatility Index ◽

Uterine Artery ◽

Resistance Index ◽

Early Screening ◽

Predictive Values ◽

Uterine Artery Doppler ◽

Doppler Study

Background: Pre-eclampsia is the most common pregnancy complication associated with serious maternal and fetal morbidity. Uterine artery Doppler reflects the impaired trophoblastic invasion of the uterine spiral arteries, which is involved in the aetiology of preeclampsia. Thus, uterine artery Doppler was proposed as a screening test for pre-eclampsia.Methods: A prospective cohort study of 100 singleton pregnancies was conducted in a tertiary centre and the study population were subjected to uterine artery Doppler study at 18-22 weeks gestation. Uterine artery Doppler indices of pulsatility index (PI), resistance index (RI) and persistence of diastolic notch was obtained and the outcome of pre-eclampsia was studied.Results: Out of 100 women, 14 women developed pre-eclampsia in which the resistance index showed a sensitivity of 21.4%, specificity of 91.8%, positive predictive value of 30% and negative predictive value of 87.7% and pulsatility index showed sensitivity of 35.7%, specificity of 90.6%, positive predictive value of 38.4% and negative predictive value of 89.6%. Diastolic notch had a sensitivity of 35.7%, specificity of 98.8%, positive predictive value of 83.3% and a negative predictive value of 90.4%.Conclusions: The high negative predictive values, indicated that women with normal Doppler velocimetry were unlikely to develop preeclampsia. Uterine artery Doppler, being non-invasive can be included during routine sonography to identify patients at risk of developing pre-eclampsia. Early, screening for pre-eclampsia will help in individualized antenatal surveillance and initiation of prophylactic therapy, early to reduce the adverse maternal and foetal complications of preeclampsia.

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Doppler study of myometrium in invasive gestational trophoblastic disease

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200409000-00034 ◽

2004 ◽

Vol 14 (5) ◽

pp. 972-979 ◽

Cited By ~ 2

Author(s):

S. Oguz ◽

A. Sargin ◽

H. Aytan ◽

S. Kelekci ◽

H. Dumanli

Keyword(s):

Color Doppler ◽

Single Agent ◽

Resistance Index ◽

Myometrial Invasion ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Color Doppler Ultrasound ◽

Gestational Trophoblastic Disease ◽

Trophoblastic Disease ◽

Doppler Study

ObjectiveIn this prospective study, we aimed to assess the prognostic and diagnostic role of color Doppler flow of myometrium in patients with invasive gestational trophoblastic disease (GTD).MethodsThirty-seven patients, who were enrolled in the study with invasive mole, were assessed with the help of transvaginal color Doppler ultrasound before and after chemotherapy. The place and the size of the myometrial invasions were assessed.ResultsThirty patients of 37 were treated with the help of single-agent chemotherapy – methotrexate (mtx). In this group, the resistance index (RI) ratios ranged between 0.26 and 0.45 and the size of the myometrial invasion varied between 10 and 50 mm. On the other hand, six patients were treated with mtx and actinomycin D combination and one patient was treated with the help of total abdominal hysterectomy. In this group, the RI ratios ranged between 0.16 and 0.25 and the size of the myometrial invasion varied between 60 and 90 mm. Remission was achieved in all patients.ConclusionTransvaginal color Doppler study can easily detect invasive GTD. When the depth and the width of the myometrial invasion increase and when there is a low diastolic/systolic ratio, the number of courses and the need for combination of chemotherapy increase.

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OP09.03: First and second trimester uterine artery Doppler study in high-risk women for preeclampsia

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.9341 ◽

2011 ◽

Vol 38 (S1) ◽

pp. 81-81

Author(s):

I. Herraiz ◽

J. M. Puente ◽

D. Escribano ◽

E. Gomez Montes ◽

I. Camaño ◽

...

Keyword(s):

High Risk ◽

Uterine Artery ◽

Second Trimester ◽

Uterine Artery Doppler ◽

High Risk Women ◽

Doppler Study

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OC212: Risk assessment of pre-eclampsia and IUGR in patients with normalization of the uterine artery Doppler study between 20 and 24 weeks

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.4318 ◽

2007 ◽

Vol 30 (4) ◽

pp. 432-432

Author(s):

M. Comas ◽

O. Gómez ◽

F. Crispi ◽

J. A. Benavides-Serralde ◽

E. Meler ◽

...

Keyword(s):

Risk Assessment ◽

Uterine Artery ◽

Uterine Artery Doppler ◽

Doppler Study

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Uterine artery Doppler study in second trimester of pregnancy

Pan African Medical Journal ◽

10.11604/pamj.2013.15.87.2321 ◽

2013 ◽

Vol 15 ◽

Cited By ~ 6

Author(s):

Olufemi Adebari Oloyede ◽

Faye Iketubosin

Keyword(s):

Uterine Artery ◽

Second Trimester ◽

Uterine Artery Doppler ◽

Doppler Study

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PREDICTION OF PREECLAMPSIA BY UTERINE ARTERY DOPPLER VELOCIMETRY BETWEEN 16-28 WEEKS

10.36106/gjra/3002070 ◽

2021 ◽

pp. 56-60

Author(s):

Ashraf M Ali ◽

Prameela Prameela ◽

Aseem Basha ◽

Sonal Garg

Keyword(s):

High Risk ◽

Predictive Value ◽

Uterine Artery ◽

Risk Group ◽

Indirect Evidence ◽

Low Risk ◽

Predictive Test ◽

Doppler Velocimetry ◽

Uterine Artery Doppler ◽

Doppler Study

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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