Uterine and umbilical artery Doppler at 28 weeks for predicting adverse pregnancy outcomes in women with abnormal uterine artery Doppler findings in the early second trimester

ObjectiveThe objective of this study was to determine the contribution of uterine (UtA) and umbilical arteries (UA) Doppler examination at 28weeks to predict adverse pregnancy outcomes in women who had increased resistance in UtA in the early second trimester. MethodsWomen with UtA mean pulsatility index (PI) above the 95th centile at 19-22weeks of gestation were offered a growth scan including Doppler examination of UtA and UA at 28weeks. Adverse pregnancy outcomes included small for gestational age (SGA), defined as birth weight below the tenth centile, preeclampsia (PE) and early-onset PE (PE before 34weeks). ResultsWe studied 266 pregnant women with elevated PI in the UtAs in the second trimester and ultrasound reassessment at 28weeks. UtA PI >95th centile at 28weeks was associated with subsequent PE [odds ratio (OR): 10.0, 95% CI: 2.3-43.5], early-onset PE (OR: 57.7, 95% CI: 3.8-87.6) and SGA less than the tenth centile (OR: 5.5, 2.2-13.9). UA PI >95th centile at 28weeks was not significantly associated with any adverse outcome. ConclusionsIn women with abnormal UtA Doppler in the early second trimester scan, persistence of elevated UtA PI, but not abnormal UA PI, is associated with adverse pregnancy outcomes including PE, early-onset PE and SGA. (c) 2014 John Wiley & Sons, Ltd.