Second Trimester Uterine Artery Doppler Screening in Prediction of Adverse Pregnancy Outcome in High Risk Women
Densak Pongrojpaw MD*, Athita Chanthasenanont MD*, Tongta Nanthakomon MD*
Affiliation : * Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Objective : To assess the value of uterine artery colour Doppler waveform analysis in the prediction of adverse pregnancy
outcome such as preeclampsia, fetal growth restriction in high risk pregnancy women.
Material and Method: Uterine artery Doppler screening was performed as part of mid trimester screening between 20 and
24 weeks gestation in high risk pregnancy women at Matermal Fetal Medicine unit, Thammasat University Hospital between
June 1, 2008 and May 31, 2009. A pulsatility index (PI) was calculated from each uterine artery and the presence or absence
of a notch was determined. A PI of > 1.58 or the presence of any diastolic notch were defined as abnormal. The main outcome
measures were pre-eclampsia and small for gestational aged baby (birth weight < 10th centile).
Results : Doppler examination of the uterine arteries were performed in 330 singleton pregnancies. Twenty-seven (8.18%)
women developed pre-eclampsia, 16 (4.84%) women had SGA babies. The sensitivity of PI > 1.58 and diastolic notch for pre-
eclampsia, SGA were 59.25% and 56.25%, respectively.The specificity of PI >1.58 and diastolic notch for these outcomes
were 66.67% and 65.60% respectively.
Conclusion : In high-risk women, mid trimester uterine artery Doppler waveform analysis can not use as screening method
in women at higher risk for the development of severe adverse outcome such as pre-eclampsia and SGA babies. However
women with normal uterine artery Doppler results are unlikely to develop pre-eclampsia, fetal growth restriction (FGR) and
therefore do not necessarily need repeated Doppler ultrasound follow-up.
Keywords : Doppler, Uterine artery, High risk pregnancy
