Notching and Pulsatility Index of the Uterine Arteries and Preeclampsia in Twin Pregnancies

Abnormal uterine artery Doppler ultrasound during gestational 21-23 weeks associated with pre-eclampsia

OBJECTIVE

To assess whether abnormal uterine artery Doppler ultrasound during weeks 21-23 of pregnancy was associated with an increased risk of pre-eclampsia.

METHODS

Our retrospective cohort study analyzed uterine artery ultrasound parameters in singleton pregnant women at 21-23 weeks of pregnancy and assessed the association between abnormal ultrasound findings and the risk of pre-eclampsia. Multivariate logistic regression analysis was conducted to estimate the relative risk between uterine artery ultrasound and pre-eclampsia.

RESULTS

Compared with normal results, unilateral pulsatile index abnormality (odds ratio [OR] 2.3, 95% confidence interval [CI] 1.71-3.10), bilateral pulsatile index anomalies (OR 6.21, 95% CI 3.53-10.95), unilateral resistance index abnormality (OR 2.36, 95% CI 1.75-3.17), bilateral resistance index anomalies (OR 2.83, 95% CI 1.27-6.32), unilateral notch (OR 3.66, 95% CI 2.03-6.62), bilateral notch (OR 5.80, 95% CI 3.30-10.20) were associated with pre-eclampsia. For every 0.1 increase in the median multiple of mean pulsatile index, the risk of pre-eclampsia increased by 13%; for every 0.1 increase in the median multiple of mean resistance index, the risk of pre-eclampsia increased by 22%.

CONCLUSION

Multiples of the median for the pulsatile and resistance indices are an effective evaluation tool. Abnormal uterine artery ultrasound indices are strongly associated with the development of pre-eclampsia.