Publication:

Colour Doppler study of uterine artery between 10-14 weeks of gestation as a predictor of intra-uterine growth restriction and preeclampsia

Background Successful pregnancy is a result of countless ongoing interactions between the placental and the maternal immune and cardiovascular systems. Pre-eclampsia and intrauterine growth restriction (IUGR) remains important causes of maternal and neonatal morbidity and mortality. These conditions arise from placental insufficiency which can be seen as alterations in waveforms in the uterine artery (UtA) in early pregnancy. We investigated the predictive accuracy of UtA Doppler indices for both conditions in the first trimester early enough to provide a window for preventive interventions.

Methods It was a prospective cohort study. (UtA) Doppler was carried out at 11-14 weeks in 100 singleton pregnancies attending for routine care. The right and left UtA were identified and velocity waveforms were obtained. Mean pulsatility index (PI), mean resistance index (RI) and diastolic notch were noted. Results were tabulated and analyzed.

Results 18% developed Preeclampsia and 16% developed IUGR. The first trimester UtA mean RI and mean PI were significantly higher in patients who are destined to develop Preeclampsia and IUGR. No significant relationship was found between IUGR, Preeclampsia and diatolic notch. Mean RI is a better predictor of IUGR and Pre-eclampsia compared to Mean PI. Using receiver operating characteristics (ROC) curve, the best cut-off of mean RI to detect the Pre-eclampsia and IUGR is 0.68.

Conclusions UtA Doppler at 11–14 weeks of gestation identifies a high proportion of women who will develop severe pre-eclampsia, and/or IUGR.