Diagnostic evaluation of uterine artery Doppler sonography for the prediction of adverse pregnancy outcomes

Background: increased impedance to flow in the uterine arteries assessed by value of the doppler is associated with adverse pregnancy outcomes, especially pre-eclampsia. we investigated the predictive value of a uterine artery doppler in the identification of adverse pregnancy outcomes such as ‘pre-eclampsia’ and ‘small fetus for gestational age’ (sga). materials and methods: three hundred and seventy-nine women, with singleton pregnancy, between 18 and 40 years of age, without risk factors, randomly underwent doppler interrogation of the uterine arteries, between 16-22 weeks of gestation. those who had a mean pulsatility index (pi) of >1.45 were considered to have an abnormal result, and were evaluated and compared with those who had normal results for adverse pregnancy outcomes, including pre-eclampsia and small for gestational age. the relationship between the variables was assessed with the use of the chi-square test. results: there were 17 cases (4.5%) of abnormal uterine artery doppler results and 15 of them (88.2%) developed pre-eclampsia and four cases (23.5%) had neonates small for gestational age. for predicting pre-eclampsia, the mean uterine artery pi had to be >1.45, had to have a specificity of 95.5% (95% ci, 70-92%), a sensitivity of 79% (95% ci, 43-82%), a negative predictive value (npv) of 98.9% (95% ci, 72-96%), and a positive predictive value (ppv) of 88.2% (95% ci, 68-98%). in the case of ‘small for gestational age’ it had to have a specificity of 96.5% (95% ci, 42-68%), a sensitivity of 57% (95% ci, 53-76%), an npv of 99.2% (95% ci, 70-92%), and a ppv of 23.5% (95% ci, 30-72%). conclusion: uterine artery doppler evaluation at 16-22 weeks of gestation might be an appropriate tool for identifying pregnancies that may be at an increased risk for development of pre-eclampsia and small fetus for gestational age.