Uterine artery Doppler screening as a predictor of pre-eclampsia
Hypertensive disorders represent the second most common cause of maternal death, affecting 5-10% of pregnancies worldwide and accounting for 19% of maternal deaths in South Africa. Pre-eclampsia is believed to develop from inadequate trophoblast invasion of the maternal spiral arteries. Doppler imaging permits non-invasive evaluation of the uteroplacental circulation and is invaluable in the management of high risk pregnancies.
A prospective quantitative experimental study tested the hypothesis that uterine artery (UA) spectral Doppler screening is able to identify patients at risk for developing preeclampsia.
Convenience sampling allowed for the recruitment of 144 patients (11-14 weeks gestation) who attended the antenatal clinic at Rahima Moosa Mother and Child Hospital between November 2008 and July 2010. A complete record of 121 participants was available for the final analysis.
The results of this study revealed that 7 (5.8%) participants developed pre-eclampsia. Race was identified as the most significant independent variable with an odds ratio of 1.5; 26 and 9 to 1 for developing PET in the 1st, 2nd and 3rd trimesters respectively.
Uterine Artery Doppler is promising. An ultrasound screening programme in high risk pregnant women would offer clinicians the opportunity to pre-empt the disease before it manifests clinically.
Keywords: High risk pregnancy, Pre-eclampsia, Uterine artery doppler, Uterine artery notching, Pulsatility index