Uterine artery Doppler: Changing Concepts in Prediction and Prevention of PE and FGR

AbstractOne of the most promising screening tools in detection of PE and FGR is uterine artery Doppler velocimetry. The underlying pathology for the development of PE is thought to be due to defective trophoblastic invasion of uterine spiral arteries. Increased impedance during mid-trimester is known to be associated with a high incidence of adverse pregnancy outcomes. High resistance in uterine arteries can be observed as early in the first trimester in cases with impaired placentation. The predictive efficacy of first trimester UtA Doppler has improved after the development of risk specific algorithm by including maternal characteristics, biophysical and biochemical parameters. With the understanding of late onset FGR and PE, it was realised that first trimester UtA Doppler may not serve as an efficient marker to identify this group which led to the evolution of its assessment in third trimester. The importance of UtA Doppler in third trimester is its ability to differentiate a physiologically small baby from a pathologically small fetus, which is growth restricted. PE and FGR remains an important cause of maternal and fetal mortality and its prediction is a challenging task which needs to be done early in gestation. Low dose aspirin when started before 16  weeks in the truly high risk population has proven to significantly reduce PE and FGR. To initiate aspirin therapy, the development of first trimester risk prediction model remains the key component. This paper is a rev...
Source: Journal of Fetal Medicine - Category: Perinatology & Neonatology Source Type: research