PMID- 9819873
OWN - NLM
STAT- MEDLINE
DCOM- 19990121
LR  - 20161124
IS  - 0960-7692 (Print)
IS  - 0960-7692 (Linking)
VI  - 12
IP  - 5
DP  - 1998 Nov
TI  - The role of color Doppler imaging of the uterine arteries at 20 weeks' gestation 
      in stratifying antenatal care.
PG  - 339-45
AB  - OBJECTIVE: To determine the value of one-stop color Doppler imaging of the 
      uterine arteries at the time of the 20-week anomaly scan, to select women at risk 
      of developing pre-eclampsia and intrauterine growth restriction (IUGR). PATIENTS 
      AND METHODS: A total of 1022 unselected women had color Doppler imaging of both 
      uterine arteries at the time of their dating/anomaly scan (19-21 weeks' 
      gestation). The presence or absence of notching of the flow velocity waveform 
      (FVW) was noted, and the resistance index (RI) was measured. The main outcome 
      measures were pre-eclampsia, birth weight, placental abruption and stillbirth. 
      RESULTS: The outcome in 946 women (92.6%) was available for analysis. Of these, 
      216 (23%) had abnormal uterine artery Doppler studies, 117 (12.4%) with bilateral 
      (right and left FVW) notches; 21 (2.2%) women developed pre-eclampsia, and 57 
      (6.0%) neonates were small for gestational age (SGA; < 5th centile), at birth. 
      For women with bilateral notches the odds ratio (OR) for developing pre-eclampsia 
      was 12.8 (95% confidence interval (CI) 5.3-30.8), and 52.6 (95% CI 6.4-430.1) for 
      pre-eclampsia requiring delivery before 37 weeks' gestation. If the uterine 
      artery Doppler studies were normal, the odds ratio for developing pre-eclampsia 
      was 0.11 (95% CI 0.04-0.28), and 0.3 (95% CI 0.17-0.51) for the delivery of an 
      SGA baby less than the 5th centile. In women with bilateral notches with mean RI 
      greater than 0.55, the positive predictive value for the main outcome measures 
      was 46%. CONCLUSION: Women with normal uterine artery color/pulsed Doppler 
      studies at 20 weeks' gestation constitute a group that have a low risk of 
      developing obstetric complications related to uteroplacental insufficiency. Women 
      with high resistance in both uterine arteries (bilateral notches) have an 
      increased risk of the subsequent development of such complications, in particular 
      those requiring delivery before term. The addition of color Doppler imaging of 
      the uterine arteries at the time of the routine 20-week dating/anomaly scan may 
      be of use in determining the type and level of antenatal care that is offered to 
      women.
FAU - Kurdi, W
AU  - Kurdi W
AD  - King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
FAU - Campbell, S
AU  - Campbell S
FAU - Aquilina, J
AU  - Aquilina J
FAU - England, P
AU  - England P
FAU - Harrington, K
AU  - Harrington K
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Ultrasound Obstet Gynecol
JT  - Ultrasound in obstetrics & gynecology : the official journal of the International 
      Society of Ultrasound in Obstetrics and Gynecology
JID - 9108340
SB  - IM
MH  - Arteries/diagnostic imaging
MH  - Female
MH  - Fetal Growth Retardation/*diagnostic imaging/physiopathology
MH  - Humans
MH  - Pre-Eclampsia/*diagnostic imaging/physiopathology
MH  - Pregnancy
MH  - Pregnancy Trimester, Second
MH  - Prenatal Care
MH  - *Ultrasonography, Doppler, Color
MH  - Ultrasonography, Doppler, Pulsed
MH  - *Ultrasonography, Prenatal/methods
MH  - Uterus/*blood supply
MH  - Vascular Resistance
EDAT- 1998/11/20 00:00
MHDA- 1998/11/20 00:01
CRDT- 1998/11/20 00:00
PHST- 1998/11/20 00:00 [pubmed]
PHST- 1998/11/20 00:01 [medline]
PHST- 1998/11/20 00:00 [entrez]
AID - 10.1046/j.1469-0705.1998.12050339.x [doi]
PST - ppublish
SO  - Ultrasound Obstet Gynecol. 1998 Nov;12(5):339-45. doi: 
      10.1046/j.1469-0705.1998.12050339.x.