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Uterine artery Doppler at 11 + 0 to 13 + 6 weeks in the prediction of pre-eclampsia

  1. W. Plasencia,
  2. N. Maiz,
  3. S. Bonino,
  4. C. Kaihura,
  5. K. H. Nicolaides*

Article first published online: 26 SEP 2007

DOI: 10.1002/uog.5157

Issue

Ultrasound in Obstetrics & Gynecology

Ultrasound in Obstetrics & Gynecology

Volume 30, Issue 5, pages 742–749, October 2007

Additional Information

How to Cite

Plasencia, W., Maiz, N., Bonino, S., Kaihura, C. and Nicolaides, K. H. (2007), Uterine artery Doppler at 11 + 0 to 13 + 6 weeks in the prediction of pre-eclampsia. Ultrasound in Obstetrics & Gynecology, 30: 742–749. doi: 10.1002/uog.5157

Author Information

  1. Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK

*Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, Denmark Hill, London SE5 8RX, UK

Publication History

  1. Issue published online: 26 SEP 2007
  2. Article first published online: 26 SEP 2007

Funded by

  • This study was supported by a grant from the Fetal Medicine Foundation (Charity No: 1037116)

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Keywords:

  • Doppler;
  • first trimester;
  • high-risk pregnancy prediction;
  • pre-eclampsia;
  • uterine artery

Abstract

Objective

To determine the performance of screening for pre-eclampsia (PET) by maternal characteristics and uterine artery pulsatility index (PI) at 11 + 0 to 13 + 6 weeks' gestation.

Methods

In women with singleton pregnancies attending for routine care at 11 + 0 to 13 + 6 weeks' gestation we recorded maternal variables and measured the uterine artery PI. We identified 107 cases that subsequently developed PET and 5041 that were unaffected by PET, gestational hypertension or delivery of newborns with birth weight below the 10th centile. A multivariate Gaussian model was fitted to the distribution of log multiples of the median (MoM) PI in the PET and unaffected groups. Likelihood ratios for log MoM PI were computed and used together with maternal variables to produce patient-specific risks for each case. Predicted detection rates (DR) and false-positive rates (FPR) were calculated by taking the proportions with risks above a given risk threshold.

Results

In the unaffected group log MoM PI was influenced by maternal ethnic origin, body mass index, previous history of PET and fetal crown–rump length. In the prediction of PET significant contributions were provided by log MoM PI, ethnic origin, body mass index and previous and family history of PET. For an FPR of 10% the DRs of all PET and PET leading to delivery before 34 weeks' gestation by log MoM PI and maternal variables were 61.7% and 81.8%, respectively.

Conclusion

Maternal variables together with uterine artery PI at 11 + 0 to 13 + 6 weeks' gestation provide sensitive prediction of the development of PET, especially of severe early-onset PET. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.

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