The Value of The Uterine Artery Doppler at 22-24 Weeks Gestation In The Prediction of Adverse Perinatal Outcome In an Unselected Population

Abstract

OBJECTIVE: To evaluate the value of uterine artery Doppler at 22-24 weeks gestation in the prediction of complications resulting from uteroplacental insufficiency in an unselected population. STUDY DESIGN: A total of 383 women underwent color flow imaging combined with pulsed wave Doppler of both uterine arteries at 22-24 weeks gestation. The mean resistance index of both uterine arteries greater than 0.58, unilateral or bilateral early diastolic notches was considered abnormal. RESULTS: The mean resistance index was greater than 0.58 in 17.5% of cases; the prevalence of unilateral and bilateral early diastolic notches was 11.5% and 3.7%, respectively. The prevalence of gestational hypertension, preeclampsia, and small for gestational age were 2.3%, 0.3%, and 10.2% respectively. The negative predictive values of abnormal resistance index, unilateral and bilateral notches for gestational hypertension were 99.1%, 98.2%, and 97.8% respectively. The negative predictive values of each parameter for babies small for gestational age were 91.8%, 92%, and 90.2% respectively. The positive predictive values of each parameter for gestational hypertension and for babies small for gestational age were less powerful. The combination of these Doppler parameters caused a slight increase in the positive predictive values compared to a single parameter. CONCLUSIONS: The screening efficacy of uterine artery Doppler at 22-24 weeks gestation for adverse perinatal outcome seems poor in population at low risk; however, normal uterine artery Doppler studies in this population could be used to estimate an uncomplicated pregnancy.

Keywords

• Gestational hypertension, Resistance index, Small for gestational age, Uterine Artery Doppler