How might uterine artery ultrasound color Doppler aid in preeclampsia prediction?

Background In pregnancies complicated by preeclampsia (PE), increased impedance in uterine arterial flow is detectable before clinical symptoms appear. Aim To evaluate the value of color Doppler study of uterine artery (UtA) in the prediction of PE in high-risk pregnancy. Patients and methods This prospective cohort research was conducted on 100 pregnant females, aged from less than 20 to more than 35 years, with a BMI more than or equal to 30.5 kg/m 2 , history of PE or eclampsia in a previous pregnancy, history of intrauterine growth restriction or stillbirth, preexisting medical disorders, and abruptio placentae. All patients were subjected to UtA Doppler in the second trimester between 18 and 22 weeks and were followed up. Results Doppler ultrasound findings were significantly higher in individuals with adverse outcomes than normal individuals. UtA resistance index (RI) and pulsatility index (PI) values showed significant predictive value of adverse outcome cases, respectively ( P <0.001), at cutoff values of more than or equal to 0.58 and more than or equal to 1.54 could predict PE case with a sensitivity of 82.35 and 94.12%, specificity of 75.9 and 93.98%, respectively. The UtA PI showed significantly better performance than UtA RI in the prediction of PE in terms of significantly higher area under the curve (0.973 compared with 0.858, respectively, P =0.049). Conclusions UtA Doppler ultrasound is an effective tool for predicting PE and other adverse pregnancy outcomes in high-risk pregnancies. Elevated Doppler indices and the presence of notches are strong indicators of adverse outcomes. The PI has proved to be a more sensitive and specific predictor compared with the RI.