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Acta Obstet Gynecol Scand. 2014 Dec;93(12):1276-81. doi: 10.1111/aogs.12488. Epub 2014 Sep 21.

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.

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1
Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, Shenyang, China.

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.

KEYWORDS:

Doppler; intra-uterine growth restriction; perinatal outcome; placenta; preeclampsia; pregnancy; ultrasound; umbilical artery; uterine artery

PMID:
25155650
DOI:
10.1111/aogs.12488
[Indexed for MEDLINE]
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