Abstract
Objective. To assess the role of uterine artery Doppler studies at 11-14 weeks in screening for pre-eclampsia (PET), small for gestational age (SGA) fetuses, and placental abruption. Methods. Prospective study on 1,123 women presenting for routine ultrasound examination at 11–14 weeks for nuchal translucency measurement. Uterine artery blood flow was studied by transvaginal colour Doppler, the mean pulsatility index (PI) was calculated, and the presence of a diastolic notch was recorded. Results. The mean, median and 95th centile of uterine artery PI were 1.71, 1.64 and 2.54, respectively. Bilateral notches were observed in 63.4%, and a unilateral notch in 18.4% of cases. The sensitivity of mean uterine artery PI ≥95th centile for PET, early onset severe PET necessitating delivery before 34 weeks, SGA ≤5th centile, SGA necessitating delivery before 34 weeks, SGA ≤10th centile and placental abruption were 21.4, 33.3, 17.8, 100, 9.6 and 44.4%, respectively. One in 6 women with increased resistance in the uterine arteries at 11–14 weeks will develop a complication related to utero-placental insufficiency. Conclusions. Abnormal uterine Dopplers at 11–14 weeks identified one-third of women with severe early onset pre-eclampsia, all fetuses with SGA ≤5th centile that were delivered at ≤34 weeks, and 40% of cases with placental abruption. Uterine artery Doppler examination at the 11–14 weeks scan can identify a high risk population in which preventive or therapeutic interventions might be effective.