Prediction of Pre-Eclampsia by Maternal Uterine Artery Doppler at 11-14 Weeks of Gestation

Uterine artery doppler is a non-invasive which can be used for prediction of PE and FGE at 20 – 23, but the 11 – 13+6 weeks scan may provide earlier information. This was a prospective observational two year study in a tertiary care center in South India. 330 in low risk, singleton pregnancies were examined between 11–13+6 weeks. In addition to CRL and NT, mean maternal uterine artery PI was measured. The women were followed till delivery to observe development of PE and FGR. Sensitivity and specificity of the mean uterine artery PI with respect to development of complications was calculated. Categorical variables were analyzed using chi square test and value of p= 0.05 was used to calculate significance Results of a total 320 women, 304 had normal PI (Group A) and 16 had PI above 95th centile. (Group B). The two groups were similar with respect to parity and BMI. In Group B, 25% developed pre-eclampsia and 12.5 developed FGR compared to 3.9% developing either PE or FGR in Group A. (p value < 0.005 and 0.01 respectively. Although the sensitivity was low (24%), the specificity and negative predictive values were over 95%, for all three outcomes studied. Thus a normal Doppler in early pregnancy may assure regarding a normotensive pregnancy. This study shows the value of adding uterine artery examination to the 11 – 13+6 week scan. Predicting development of complications in a low risk cohort provides adequate time to add aspirin to reduce the risk of complications. This is the first reported study from South India. Larger studies from this population with addition of serum biochemical parameters such as PAPP A and PLGF will be of added value in this field of study.