SCREENING FOR PREECLAMPSIA BY UTERINE ARTERY DOPPLER VELOCIMETRY IN THE LATE FIRST TRIMESTER OF PREGNANCY
Abstract
The Authors prospectively determined the uterine artery Doppler velocimetry (UADV) in 108 women with a history of hypertensive disorder of pregnancy (HDP) between the 10th and 13th week of pregnancy to identify those at higher risk for recurrent preeclampsia and to evaluate the efficacy of prophylactic pharmacological treatment in this subgroup of patients. Patients with abnormal flow values (RI > 0.58 and any notching) were immediately started on aspirin 100 mg/daily, replaced by daily subcutaneous injection of low molecular weight heparin from the 24th week till delivery. Concerning the maternal morbidity (expressed by abnormal both mean blood pressure and 24-hour proteinuria throughout pregnancy), the Authors found that the average pregnancy course in 20 (18.5%) prophylactic treated patients with altered 1st trimester UADV (group A) was better than in their previous pregnancies, however regarding the above parameters no significant difference (P > 0.05) was found between the patients treated and another cohort of patients (n =20), also extrapolated from the same pool of patients at risk for HDP, but with normal I trimester UADV studies (group B) who were not prophylactic treated. Both groups of patients were followed up from the time of Doppler studies until 6 weeks postpartum. The study suggests that UADV in the late first trimester of pregnancy is useful in reducing the risk of preeclampsia in patients with a history of HDP, allowing the prompt institution of prophylactic treatment in selected patients.
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References
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