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Obstetrics and Gynecology International
Volume 2009, Article ID 275613, 6 pages
http://dx.doi.org/10.1155/2009/275613
Research Article

Maternal History and Uterine Artery Doppler in the Assessment of Risk for Development of Early- and Late-Onset Preeclampsia and Intrauterine Growth Restriction

1Department of Obstetrics, Fetal Medicine Unit, Vall d'Hebron Hospital, Universitat Autònoma de Barcelona, 08035-Barcelona, Spain
2Department of Obstetrics, Son Llatze Hospital, Mallorca, Spain
3Department of Obstetrics, Granoller Hospital, Barcelona, Spain
4Department of Obstetrics, Terrassa Hospital, Barcelona, Spain
5Department of Stadistics, Vall d'Hebron Hospital, Universitat Autònoma de Barcelona, 08035-Barcelona, Spain

Received 29 September 2008; Revised 27 February 2009; Accepted 12 March 2009

Academic Editor: Robert L. Coleman

Copyright © 2009 Elisa Llurba et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To examine the value of one-step uterine artery Doppler at 20 weeks of gestation in the prediction pre-eclampsia (PE) and/or intrauterine growth restriction (IUGR). Methods. A prospective multicentre study that included all women with singleton pregnancies at 19–22 weeks of gestation (w). The mean pulsatility index (mPI) of both uterine arteries was calculated. Receiver-operating characteristics curves (ROC) were drawn to compare uterine artery Doppler and maternal risk factors for the prediction of early-onset PE and/or IUGR (before 32 w) and late-onset PE and/or IUGR. Results. 6,586 women were included in the study. Complete outcome data was recorded for 6,035 of these women (91.6%). PE developed in 75 (1.2%) and IUGR in 69 (1.1%) cases. Uterine Doppler mPI was 0.99 and the 90th centile was 1.40. For 10% false-positive rate, uterine Doppler mPI identified 70.6% of pregnancies that subsequently developed early-onset PE and 73.3% of pregnancies that developed early-onset IUGR. The test had a lower detection rate for the late-onset forms of the disease (23.5% for PE and 30% for IUGR). Maternal history has a low sensitivity in the detection of early-onset cases, although it is better at detecting late-onset PE. Conclusion. Uterine artery Doppler and maternal risk factors seem to select two different populations - early and late-onset PE which might suggest a different pathogenesis.