Uterine artery Doppler in high-risk pregnancies at 23-24 gestational weeks is of value in predicting adverse outcome of pregnancy and selecting cases for more intense surveillance.

Abstract:

OBJECTIVE:To assess the role of the placental arterial Doppler examination at 23-24 gestational weeks for predicting adverse perinatal outcome in high-risk pregnancies. DESIGN:Retrospective register study. SETTING:Skåne University Hospital in Malmö. POPULATION:Six hundred and forty-five women with high-risk pregnancies, without fetal malformations or chromosomal abnormalities. METHODS:Placental (uterine and umbilical artery) Doppler ultrasound examination at 23-24 gestational weeks. MAIN OUTCOME MEASURES:Adverse perinatal outcomes including preeclampsia, small-for-gestational age newborns (smaller than 3rd percentile or smaller than the 10th percentile), preterm delivery (<34 weeks or <37 weeks of gestation at delivery), cesarean section, admission to the neonatal intensive care unit and intra-uterine fetal death. RESULTS:Abnormal uterine artery Doppler values were detected in 45% of this high-risk group but abnormal umbilical artery Doppler indices were only seen in 3.7%. Adverse perinatal outcome increased significantly with increasing placental vascular impedance (p < 0.0001). There were seven cases of intrauterine fetal death and in five the uterine artery Doppler values at 23-24 weeks were abnormal. A strong correlation between abnormal uterine artery Doppler and preeclampsia was present, but not with other forms of hypertensive disorder. CONCLUSION:Placental Doppler screening at 23-24 weeks can be used in detecting pregnancies at risk of adverse outcome and in selecting cases for more intense surveillance. A surveillance plan is proposed based on Doppler screening at 23-24 weeks of gestation.

authors

Li N,Ghosh G,Gudmundsson S

doi

10.1111/aogs.12488

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

1276-81

issue

12

eissn

0001-6349

issn

1600-0412

journal_volume

93

pub_type

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