Uterine artery Doppler and pregnancy complications in unselected women

Purpose: Pre-eclampsia and fetal growth restriction are two of the most common causes of maternal and fetal morbidity and mortality. A population of low-risk women was screened by uterine artery Doppler for diastolic notch. A good performance of this screening method could help to detect high-risk pregnancies at an early stage in order to increase the patient surveillance. Patients and methods: Between January and December 2002, uterine artery color Doppler was performed by one single researcher in 578 healthy pregnant women between 20 and 24 weeks of gestation in order to detect bilateral diastolic notches. A bilateral notch in at least three consecutive heart cycles was considered positive. Results (specificity, sensitivity, positive predictive value, negative predictive value) were calculated for preeclampsia, small-for-gestational-age infants and delivery before 37 weeks of gestation. Results: A bilateral notch was found in 36 (7%) of 490 women, who remained in the study. The risk of developing one of the examined diseases was significantly increased in the notch group. Doppler ultrasound showed high specificity and high negative predictive values for all of the three diseases. Conclusion: Doppler screening for bilateral notching helps to avoid unnecessary examinations of women with normal uterine artery waveforms. On the other hand, women with bilateral notching benefit from early increased surveillance.