Role of Uterine Artery Doppler in the First-trimester in Prediction of Pre-eclampsia.

Authors

1 Professor of Obstetrics and Gynecology, Faculty of Medicine, Al- Azhar University, Cairo, Egypt.

2 Lecturer of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

3 Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Abstract

Background: Abnormal uteroplacental vasculature early in pregnancy may result in pre-eclampsia, which has linked to increased risk for serious morbidity or mortality. Doppler study of the uterine artery (UtA) as a standalone biomarker, using pulsatility index (PI) or notching, may help to identify the at-risk women in the 1st trimester of pregnancy. Objective: This research aimed to assess the potential of 1st trimester UtA Doppler ultrasound for the early diagnosis of pre-eclampsia, in at-risk pregnant cases. Patients and methods: A prospective, observational, cohort investigation was conducted on 120 singleton viable pregnant cases at hazard for pre-eclampsia. Doppler ultrasound at (110/7–136/7) weeks was performed on both uterine arteries and the potential of mean UtA-PI and notch was evaluated for its usefulness in prediction of pre-eclampsia. 120 cases were categorized into two groups according to the pregnancy evolution as follows: Group I (Pre-eclampsia group) included 14 cases with pre-eclampsia. Group II (Control group) included 106 without pre-eclampsia. Results: Both groups had demographic data that were comparable to one another. UtA-PI was significantly greater in the pre-eclampsia group as contrasted with the control group. Based on the results of ROC curve analysis, PI can significantly predict pre-eclampsia with (AUC of 0.709, P value of 0.022), At cut-off >1.91, it gives 71.43% sensitivity, 66.98% specificity, 22.2% PPV and 94.7% NPV. Conclusion: This study concluded that UtA Doppler PI assessment in the 1st trimester (110/7–136/7) weeks is a screening method that is both effective and non-invasive for the development of pre-eclampsia in at-risk pregnant women.

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