Prediction of Recurrent Preeclampsia Using First-Trimester Uterine Artery Doppler

Abstract

Objective To evaluate the role of first-trimester uterine artery Doppler in the prediction of recurrent preeclampsia (PE).

Methods Uterine artery pulsatility index (UtPI) was measured at 11 to 13 weeks' gestation in 1,810 women with singleton pregnancies who had developed PE in a previous pregnancy. They were categorized into three subgroups according to UtPI multiple of median (MoM): < 1.0, 1.0 to 1.49, and ≥ 1.50 MoM. The rate of early onset PE (< 34 weeks), intermediate PE (34 to 36 weeks), late PE (≥ 37 weeks), perinatal death, and small-for-gestational-age outcome (SGA; below the 5th percentile) were compared between each subgroup.

Results The median mean UtPI decreased with advancing crown-rump length (CRL) from 1.77 at CRL of 45 to 54 mm to 1.52 at CRL of 75 to 84 mm. UtPI < 1.0 MoM was associated with a low-risk of early PE (0.2%), intermediate PE (0.3%), perinatal death (0.3%), and SGA (3.3%). The risk for these complications increases with UtPI of 1.0 to 1.4 MoM or ≥ 1.5 MoM (early PE 2.8 and 14.3%, respectively, p < 0.001; intermediate PE 2.1 and 5.4%, p < 0.001; perinatal death 1.3 and 6.8%, p < 0.001; and SGA 8.0 and 20.9%, p < 0.001).

Conclusion In women with previous PE, first-trimester UtPI discriminates women at high and low risk for recurrence of PE and adverse pregnancy outcomes.

Keywords

uterine artery - Doppler - prediction - preeclampsia

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