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

作者：Li, Na; Ghosh, Gisela; Gudmundsson, Saemundur^*

来源：Acta Obstetricia et Gynecologica Scandinavica, 2014, 93(12): 1276-1281.

DOI：10.1111/aogs.12488

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

ObjectiveTo assess the role of the placental arterial Doppler examination at 23-24 gestational weeks for predicting adverse perinatal outcome in high-risk pregnancies.
DesignRetrospective register study.
SettingSkane University Hospital in Malmo.
PopulationSix hundred and forty-five women with high-risk pregnancies, without fetal malformations or chromosomal abnormalities.
MethodsPlacental (uterine and umbilical artery) Doppler ultrasound examination at 23-24 gestational weeks.
Main outcome measuresAdverse perinatal outcomes including preeclampsia, small-for-gestational age newborns (smaller than 3rd percentile or smaller than the 10th percentile), preterm delivery (<34weeks or <37weeks of gestation at delivery), cesarean section, admission to the neonatal intensive care unit and intra-uterine fetal death.
ResultsAbnormal 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 23-24weeks were abnormal. A strong correlation between abnormal uterine artery Doppler and preeclampsia was present, but not with other forms of hypertensive disorder.
ConclusionPlacental Doppler screening at 23-24weeks 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 23-24weeks of gestation.

• 出版日期2014-12
• 单位中国医科大学