Article information
Resumen
Objetivo
Estudiar el papel del Doppler de las arterias uterinas como método de cribado para la predicción de preeclampsia.
Material y métodosMaterial y métodos: Estudio prospectivo a 320 gestantes no seleccionadas en la semana 20, se utiliza el índice de resistencia medio de ambas arterias uterinas a diferentes niveles de corte para la predicción de preeclampsia.
ResultadosLa prevalencia de preeclampsia fue de 3,44%. Según el percentil de corte aplicado: P-75, P-90, P-95, se obtiene una población con cribado positivo del 27,81, 11,5 y 5,95%, respectivamente, con sensibilidades del 72,7, 54,5 y 45,45%.
ConclusionesEl Doppler de arterias uterinas a la semana 20 es una herramienta útil, aunque las posibilidades de actuación sean escasas en la población seleccionada.
Palabras clave:
Doppler de arterias uterinas
Indice resistencia
Preeclampsia
Abstract
Objective
To study the role of uterine artery doppler as a screening method for the prediction of pre-eclampsia.
Material and methodsA prospective study is made in 320 unselected pregnant women at 20 weeks of gestation. The mean resistance index is used in several cut-off levels in both uterine arteries to predict Pre-eclampsia.
ResultsPre-eclampsia prevalence was 3.44%. According to cut- off level used P-75, P-90, P-95 a screening positive population of 27.81%, 11.5%, and 5.95% respectively, is obtained with sensitivities of 72.7%, 54.5%, and 45.45%.
ConclusionsUterine artery doppler at 20 weeks is a useful tool, althoug the possibilities of management are limited in a selected population.
Key words:
Uterine artery Doppler
Resistance index
Preeclampsia
Full text is only aviable in PDF
Bibliografía
[1.]
T. Kong, F. De Wolf, W.B. Robertson, I. Brosens.
Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infant.
Br J Obstet Gynaecol, 93 (1986), pp. 1049-1059
[2.]
S. Campbell, J. Díaz-Recasens, D.R. Griffin, T.E. Cohen-Overbeek, J.M. Pearce, K. Willson, et al.
New Doppler technique for assessing uteroplacental blood inflow.
Lancet, 1 (1983), pp. 675-677
[3.]
R. Pinenborg, J.M. Bland, W.B. Robertson, I. Brosens.
Uteroplacental arterial changes related to interstitial trophoblast migration in early human pregnancy.
Placenta, 4 (1983), pp. 397-414
[4.]
B.J. Trudinger, W.B. Giles, C.M. Cook.
Uteroplacental blood flow velocity-time waveforms in normal and complicated pregnancy.
Br J Obstet Gynaecol, 92 (1995), pp. 39-45
[5.]
A. Fleischer, H. Schulman, G. Farmakides, L. Bracero, L. Grunfeld, B. Rochelson, et al.
Uterine artery Doppler velocimetry in pregnant women with hypertension.
Am J Obstet Gynecol, 154 (1986), pp. 806-813
[6.]
S. Campbell, J.M. Pearce, G. Hackett, T. Cohen-Overbeek, C. Hernández.
Qualitative assessment of uteroplacental blood flow: early screening test for high-risk pregnancies.
Obstet Gynecol, 68 (1986), pp. 649-653
[7.]
S.A. Steel, J.M. Pearce, P. McParland, G.V.P. Chamberlain.
Early Doppler ultrasound screening on prediction of hypertensive disorders of pregnancy.
Lancet, 335 (1990), pp. 1548-1551
[8.]
J.P. Newnham, L.L. Patterson, I.R. James, D.A. Diepeveen, S.E. Reid.
An evaluation of the efficacy of doppler flow velocity waveforms analysis as a screening test in pregnancy.
Am J Obstet Gynecol, 162 (1990), pp. 403-410
[9.]
S. Bewley, D. Cooper, S. Campbell.
Doppler investigation of uteroplacental blood flow resistance in the second trimester: a screening study for pre-eclampsia and intrauterine growth retardation.
Br J Obstet Gynaecol, 98 (1991), pp. 871-879
[10.]
F. Goffinet, D. Aboulker, J. Paris-Llado, M. Bucourt, M. Uzan, E. Papiernik, et al.
Screening with a uterine doppler in low risk pregnant women followed by low dose aspirin in women with abnormal results: a multicenter randomised controlled trial.
B J Obstet Gynaecol, 108 (2001), pp. 510-518
[11.]
M.A. Coleman, L.M. McCowan, R.A. North.
Mid-trimester uterine artery Doppler screening as a predictor of adverse pregnancy outcome in high-risk women.
Ultrasound Obstet Gynecol, 15 (2000), pp. 7-12
[12.]
S. Bower, S. Vyas, S. Campbell, K.H. Nicolaides.
Color Doppler imaging of the uterine artery in pregnancy: normal ranges of impedance to blood flow, mean velocity and volume of flow.
Ultrasound Obstet Gynecol, 2 (1992), pp. 261-265
[13.]
K. Harrington, D. Cooper, C. Lees, K. Hecher, S. Campbell.
Doppler ultrasound of the uterine arteries: the importance of bilateral notching in the prediction of pre-eclampsia, placental abruption or delivery of a small-for-gestational-age baby.
Ultrasound Obstet Gynecol, 7 (1996), pp. 182-188
[14.]
P. Zimmermann, V. Eirio, J. Koskinen, E. Kujansuu, T. Ranta.
Doppler assesments of the uterine and uteroplacental circulation in the second trimester in pregnancies at high risk for pre-eclampsia and/or intrauterine growth retardation: comparison and correlation between different Doppler parameters.
Ultrasound Obstet Gynecol, 9 (1997), pp. 330-338
[15.]
G. Albaiges, H. Missfelder-Lobo, C. Lees, M. Parra, K.H. Nicolaides.
One-stage screening for pregnancy complications by color doppler assessment of the uterine arteries at 23 weeks’ gestation.
Obstet Gynecol, 96 (2000), pp. 559-564
[16.]
F.Y. Chan, T.C. Pun, C. Lam, J. Khoo, C.P. Lee, Y.H. Lam.
Pregnancy sgrenning by uterine artery doppler velocimetry- which criterion performs best?.
Obstet Gynecol, 85 (1995), pp. 596-602
[17.]
S. Bower, J. Kingdom, S. Campbell.
Objective and subjective assesment of abnormal uterine artery Doppler flow velocity waveforms.
Ultrasound Obstet Gynecol, 12 (1998), pp. 260-264
[18.]
S. Bower, S. Bewley, S. Campbell.
Improved prediction of preeclampsia by two-stage screening of uterine arteries using the early diastolic notch and color Doppler imaging.
Obstet Gynecol, 82 (1993), pp. 78-83
[19.]
O. Irion, J. Massé, J.C. Forest, J.M. Moutquin.
Prediction of preeclampsia, low birthweight for gestation and prematurity by uterine artery blood flow velocity waveforms analysis in low risk nulliparous women.
Br J Obstet Gynaecol, 105 (1998), pp. 422-429
[20.]
R.A. North, C. Ferrier, D. Long, K. Townend, P. Kincaid-Smith.
Uterine artery doppler flow velocity waveforms in the second trimester for the prediction of preeclampsia and fetal growth retardation.
Obstet Gynecol, 3 (1994), pp. 378-386
[21.]
S. Bewley, S. Campbell, D. Cooper.
Uteroplacental Doppler flow velocity waveforms in the second trimester. A complex circulation.
Br J Obstet Gynaecol, 96 (1989), pp. 1040-1046
[22.]
W. Kurdi, S. Campbell, J. Aquilina, P. England, K. Harrington.
The role of color Doppler imaging of the uterine arteries at 20 weeks gestation in stratifying antenatal care.
Ultrasound Obstet Gynecol, 12 (1998), pp. 339-345
[23.]
J. Aquilina, A. Barnett, O. Thompson, K. Harrington.
Comprehensive analysis of uterine artery flow velocity waveforms for the prediction of pre-eclampsia.
Ultrasound Obstet Gynecol, 16 (2000), pp. 163-170
[24.]
S. Bower, K. Schuchter, S. Campbell.
Doppler ultrasound screening as part of routine antenatal scanning: prediction of preeclampsia and intrauterine growth retardation.
Br J Obstet Gynaecol, 100 (1993), pp. 989-994
[25.]
A.T. Papageorghiou, C.K.N. Yu, R. Bindra, G. Pandis, K.H. Nicolaides.
Multicenter screening for preeclampsia and fetal growth restriction by transvaginal uterine artery doppler at 23 weeks of gestation.
Ultrasound Obstet Ginecol, 18 (2001), pp. 441-449
[26.]
P. Chien, N. Arnott, A. Gordon, P. Owen, K. Khan.
How useful is uterine artery doppler flow velocimetry in the prediction of pre-eclampsia, intrauterine growth retardation and perinatal death? An overview.
B J Obstet Gynaecol, 107 (2000), pp. 196-208
[27.]
K. Harrington, W. Kurdis, J. Aquilina, S. Campbell.
A prospective management study of slow-release aspirin in the palliation of utero-placental insufficiency predicted by uterine artery Doppler at 20 weeks.
Ultrasound Obstet Gynecol, 15 (2000), pp. 13-18
[28.]
A. Martin, R. Bindra, P. Curcio, S. Cicero, K. Nicolaides.
Screening for pre-eclampsia and fetal growth restriction by uterine artery doppler at 11-14 weeks of gestation.
Ultrasound Obstet Gynecol, 18 (2001), pp. 583-586
[29.]
CLASP (Collaborative Low dose Aspirin Study in Pregnancy).
A randomized trial of low dose aspirin for the prevention and treatment of preeclampsia among 9364 pregnant women.
Lancet, 343 (1994), pp. 619-629
[30.]
S. Caritis, B. Sibai, J. Hauth, D. Marshall, M. Lindheimer, M. Klebanoff, et al.
Low dose aspirin to prevent preeclampsia in women at high risk.
N Engl J Med, 338 (1998), pp. 701-705
Copyright © 2004. Sociedad Española de Ginecología y Obstetricia