Review article
Doppler assessment of uteroplacental blood flow in screening for preeclampsia
Katja Vince
orcid.org/0000-0001-5992-5030
; University Hospital Merkur
Pavo Perković
; University Hospital Merkur
Ratko Matijević
orcid.org/0000-0003-1693-7474
; University Hospital Merkur; Department of Obstetrics and Gynaecology, School of Medicine, University of Zagreb
Abstract
Preeclampsia complicates between 4–5 percent of pregnancies and it is one of the leading causes of maternal and perinatal mortality and morbidity worldwide. One potential screening tool for identifying pregnant women at risk for developing pre-eclampsia is Doppler assessment of blood flow in uterine arteries (UtA) and some other parts of uteroplacental circulation. Studies suggest that abnormal UtA waveforms (abnormal resistance index (RI), pulsatility index (PI) or diastolic notching) reflects impaired uteroplacental blood flow due to failed second wave of trophoblastic invasion of spiral arteries, and identify women at high risk of developing preeclampsia. Still, due to high false-positive rates, low sensitivity and low positive predictive values the majority of international guidelines do not recommend the use of UtA Doppler in clinical practice. Until more evidence, perinatal care should still focus on taking a detailed medical history, assessing for risk factors and measuring blood pressure at each prenatal visit and if classified as high risk, to use some other screening methods. Also, a growing amount of evidence suggests that pregnant women presenting with one recognized high risk factors or two or more moderate risk factors for developing pre-eclampsia should be offered low-dose aspirin from 12 weeks gestation in order to reduce the risk of developing preeclampsia.
Keywords
Pre-eclampsia; uterine artery Doppler; screening; prevention
Hrčak ID:
251882
URI
Publication date:
1.1.2019.
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