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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

Li, Na; Ghosh, Gisela LU and Gudmundsson, Saemundur LU (2014) In Acta Obstetricia et Gynecologica Scandinavica 93(12). p.1276-1281
Abstract
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,... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Doppler, ultrasound, pregnancy, placenta, uterine artery, umbilical, artery, preeclampsia, intra-uterine growth restriction, perinatal, outcome
in
Acta Obstetricia et Gynecologica Scandinavica
volume
93
issue
12
pages
1276 - 1281
publisher
Wiley-Blackwell
external identifiers
  • wos:000344876200009
  • scopus:84912043452
ISSN
1600-0412
DOI
10.1111/aogs.12488
language
English
LU publication?
yes
id
7eba7430-5fe1-4668-ac16-467543eb315a (old id 4982790)
date added to LUP
2015-02-03 07:11:36
date last changed
2017-11-05 03:55:13
@article{7eba7430-5fe1-4668-ac16-467543eb315a,
  abstract     = {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 (&lt;34weeks or &lt;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&lt;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.},
  author       = {Li, Na and Ghosh, Gisela and Gudmundsson, Saemundur},
  issn         = {1600-0412},
  keyword      = {Doppler,ultrasound,pregnancy,placenta,uterine artery,umbilical,artery,preeclampsia,intra-uterine growth restriction,perinatal,outcome},
  language     = {eng},
  number       = {12},
  pages        = {1276--1281},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {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},
  url          = {http://dx.doi.org/10.1111/aogs.12488},
  volume       = {93},
  year         = {2014},
}