Pregnancy hypertension and uterine artery Doppler ultrasound

Current Opinion in Obstetrics and Gynecology

Volumn 8, Issue 6, 1996, Pages 435-440

  Aquilina, Joseph ^a   Harrington, Kevin ^a  

^a HOMERTON UNIVERSITY HOSPITAL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID;

CLINICAL TRIAL; DIAGNOSTIC VALUE; DOPPLER ECHOGRAPHY; HUMAN; MATERNAL HYPERTENSION; PREECLAMPSIA; PRENATAL DIAGNOSIS; PRIORITY JOURNAL; REVIEW; UTERINE ARTERY; WAVEFORM;

EID: 0030450419     PISSN: 1040872X     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001703-199612000-00009     Document Type: Review

References (31)

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3. Robertson WB, Khong TV: Pathology of the uteroplacental bed. In Hypertension in Pregnancy. Edited by Sharp F, Symonds EM. Ithaca, New York: Perinatology Press; 1987:289-300.
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7. Lockwood CJ, Peters JH: Increased plasma levels of EDI+ cellular fibronectin precede the clinical signs of pre-eclampsia. Am J Obstet Gynecol 1990, 162:358-362.
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9. Sorensen TK, Williams MA, Zingheim RW, Clement SJ, Hickok DE: Elevated second-trimester human chorionic gonadotropin and subsequent pregnancy-induced hypertension. Am J Obstet Gynecol 1993, 169:834-838.
10. Dickey RP, Hower JF: Ultrasonographic feature of uterine blood flow during pregnancy and the first 16 weeks of pregnancy. Hum Reprod 1995, 10(9):2448-2452.
11. Jurkovic D, Jauniaux E, Kurjak A, Hustin J, Campbell S, Nicolaides KH: Transvaginal color Doppler assessment of the uteroplacental circulation in early pregnancy. Obstet Gynecol 1991, 77:365-369.
12. Harrington K, Goldfrad C, Carpenter RG, Campbell S: Transvaginal uterine and umbilical artery Doppler between 12-16 weeks and the subsequent development of pre-eclampsia and intrauterine growth retardation. Ultrasound Obstet Gynecol 1996 (in press).
13. Harrington K, Campbell S (Eds): The uterine circulation in pregnancy. In A Colour Atlas of Doppler Ultrasonagraphy in Obstetrics. London: Edward Arnold; 1995:35-46.
14. Bower S, Schucter K, Campbell S: Doppler ultrasound screening as part of routine antenatal screening: prediction of pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol 1993, 100:989-994.
15. Campbell S, Pearce JM, Hackett G, Cohen-Overbeek TE, Hernandez C: Qualitative assessment of uteroplacental blood flow: early screening test for high risk pregnancies. Obstet Gynecol 1984, 68:649-653.
16. Hanretty KP, Primrose M, Neilson JP, Whittle MJ: Pregnancy screening by Doppler uteroplacental and umbilical artery waveforms. Br J Obstet Gynaecol 1989, 96:1163-1167.
17. Steel SA, Pearce JM, Chamberlain GV: Early ultrasound screening in prediction of hypertensive disorders of pregnancy. Lancet 1990, 335:1548-1552.
18. Bewley S, Cooper D, Campbell S: Doppler investigation of uteroplacental blood flow in the second trimester: a screening study for pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol 1991, 198:871-879.
19. Bower S, Bewley S, Campbell S: Improved prediction of preeclampsia by two-stage screening of uterine arteries using the early diastolic notch and color Doppler imaging. Obstet Gynecol 1993, 82:78-83.
20. North RA, Ferrier C, Long D, Townend K, Kincaid-Smith P: Uterine artery Doppler flow velocity waveforms in the second trimester for the prediction of pre-eclampsia and fetal growth retardation. Obstet Gynecol 1994, 83:378-386.
21. Sato H: A study for predicting toxemia of pregnancy by the diastolic notch in the pulsed Doppler flow velocity waveforms of the uterine arteries - quantitative analysis. Nippon Sanka Fujinka Gakkai Zasshi 1995, 47:1055-1062.
22. Chan FY, Pun TC, Lam C, Khoo J, Lee CP, Lam YH: Pregnancy screening by uterine artery doppler velocimetry - which criterion peforms best? Obstet Gynecol 1995, 85:596-602. In this study, 334 women considered to be at 'medium risk' for preeclampsia were recruited and Doppler studies performed at 20, 28, and weeks. The best predictive criterion was a combination of RI above the 90th centile and the presence of bilateral diastolic notches at 20 weeks.
23. Harrington K, Cooper D, Lees C, Hecher K, Campbell S: 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 1996, 7:182-188. In this study, 1326 low-risk women were recruited at 20 weeks with a second examination at 24 weeks for women with persistent notching. Persistent notching at 24 weeks identified half the women who subsequently developed pre-eclampsia and over 80% of those who required delivery before 34 weeks.
24. Todros T, Ferrazzi E, Arduini D, Bastonero S, Bezzacheri V, Biolcati M, Bonazzi B, Gabrielli S, Pilu GL, Rizzo G et al.: Performance of Doppler ultrasonagraphy as a screening test in low risk pregnancies: results of a murticentric study. J Ultrasound Med 1995, 14(5):343-348. This multi-centre study recruited 916 low-risk pregnant women and two-stage examinations were performed at 19-24 and 26-31 weeks. The authors concluded that Doppler examinations of the uterine and umbilical arteries in mid-pregnancy are only useful in the detection of the severe forms of pregnancy-induced hypertension and small-for-gestational-age fetuses, and that the test is ineffective in populations with low prevalence of the diseases.
25. Konchak PS, Bernstein IM, Capeless MD: Uterine artery Doppler velocimetry in the detection of adverse obstetric outcomes in women with unexplained elevated maternal serum α-fetoprotein levels. Am J Obstet Gynecol 1995, 173:1115-1119. A study of 103 subjects at 17-22 weeks' gestation with unexplained high alpha-fetoprotein levels who underwent uterine artery Doppler examination. The authors conclude that an abnormal uterine artery Doppler scan is associated with an increased frequency of adverse pregnancy outcome, mainly pre-eclampsia. The best predictor was the uterine notch.
26. Murokashi T, Sekizuka N, Takakuwa K, Yoshizawa H, Tanaka K: Uterine and spiral artery velocity waveforms in pregnancy-induced hypertension and/or intrauterine growth retardation. Ultrasound Obstet Gynecol 1996, 7:122-126. A cross-sectional study of the spiral and uterine arteries in women at 18-41 weeks' gestation. A reference range for the RI of the spiral artery in relation to duration of gestation was established. The diagnostic accuracy of spiral artery RI was better than that of the presence of a diastolic notch in pregnancies already complicated by pregnancy induced hypertension and/or intrauterine growth retardation.
27. Expert Maternity Group: Changing Childbirth: the Report of the Expert Maternity Group. London: HMSO; 1993 (Cumberledge Report).
28. Talbert DG: Uterine flow velocity waveform shape as an indicator of maternal and placental development failure mechanisms: a model-based synthesising approach. Ultrasound Obstet Gynecol 1995, 6:261-271. Describes a software model of the uteroplacental blood path and its use to investigate possible interactions within the uteroplacental unit.
29. Morris JM, Fay RA, Ellwood DA, Cook CM, Devonald KJ: A randomised control trial of aspirin in patients with abnormal uterine artery blood flow. Obstet Gynecol 1996, 87:74-78. In this study, 955 nulliparous women were screened at the 18-week anomaly scan. Entry criteria for the treatment study were systolic/diastolic ratio exceeding 3.3 (mean plus two standard deviations), or in the presence of an ipsilateral notch and systolic/diastolic ratio exceeding 3.0. The authors concluded that low-dose aspirin did not reduce the incidence of pregnancy complications in the 102 women randomized.
30. Bower S, Harrington KF, Schuchter K, McGirr K, Campbell S: Prediction of pre-eclampsia by abnormal uterine Doppler ultrasound and modification by aspirin. Br J Obstet Gynaecol 1996, 103:625-629. The entry criterion for this randomized controlled study was the presence of bilateral notching at 24 weeks. The authors conclude that low-dose aspirin may reduce the incidence of severe pre-eclampsia in the 63 women randomized to aspirin or placebo.
31. Grant M: Multicentre trials in obstetrics and gynaecology. Br J Obstet Gynaecol 1996, 103:599-602. The reasons for failure of the Collaborative Study of Low-Dose Aspirin in Pregnancy trial are explored and the importance of proper choice of entry criteria for any future randomized controlled trials is underlined.