UTERINE ARTERY DOPPLER FLOW INDICES FROM 11 TO 14 WEEKS GESTATIONAL AGE

UTERINE ARTERY DOPPLER FLOW INDICES FROM 11 TO 14 WEEKS GESTATIONAL AGE

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Title:	UTERINE ARTERY DOPPLER FLOW INDICES FROM 11 TO 14 WEEKS GESTATIONAL AGE
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Article_Title:	UTERINE ARTERY DOPPLER FLOW INDICES FROM 11 TO 14 WEEKS GESTATIONAL AGE
Authors:	V. Daşcău1, Gh. Furău1, C. Furău1, Cristina Onel1, Casiana Stănescu2, Liliana Tătaru1, Cristina Ghib-Para3, Cristina Popescu4, Maria Puschita5
Affiliation:	1Department of Obstetrics and Gynecalogy, „Vasile Goldiş” Western University, Arad, Romania 2Department of Anatomy, „Vasile Goldiş” Western University, Arad, Romania 3Department of Haematology, „Vasile Goldiş” Western University, Arad, Romania 4Department of Life Sciences, „Vasile Goldiş” Western University, Arad, Romania 5Department of Internal Medicine, „Vasile Goldiş” Western University, Arad, Romania
Abstract:	Uterine artery Doppler flow screening studies during the 11th and 14th weeks of pregnancy have been shown to be important in the prediction and prevention of pregnancy complications preeclampsia and IUGR in pregnant women. Our study of the Doppler flow indices of the uterine arteries involves 216 patients examined in our clinic, with pregnancies ranging from 11 weeks + 0 days to 13 weeks + 6 days. There were 83 patients from 11 weeks + 0 days to 11 weeks + 6 days (38.43%), 61 from 12 weeks + 0 days to 12 weeks + 6 days (28.25%), and 72 from 13 weeks + 0 days to 13 weeks + 6 days (33.33%). The values of the Doppler indices were: PI 1.75±0.78, 1.89± 0.80, 1.75±0.80, and 1.57±0.70, RI 0.73±0.13, 0.75±0.13, 0.72±0.13, and 0.70±0.13, and PI/RI 2.31±0.71, 2.43±0.74, 2.32±0.70, and 2.16±0.65 for the entire group and for the three intervals respectively. There were 105 (48.61%), 37 (17.13%, with 21 cases or 55.76% on the right side), and 74 (34.26%) patients with bilateral, unilateral and absent uterine artery notching, respectively. The Doppler indices for the three aforementioned groups were: 2.11±0.77, 1.59±0.69, and 1.30±0.55 for the PI, 0.79±0.10, 0.71±0.13, and 0.65±0.14 for the RI, and 2.63±0.70, 2.18±0.64, and 1.92±0.50 for the PI/RI, respectively. The indices for the arteries with and without notching in all patients, as well as for the uterine arteries with and without notching in patients with unilateral notching, were 2.10±0.75, 1.27±0.53, 2.01±0.67, and 1.18±0.42 for the PI, 0.78±0.10, 0.65±0.13, 0.78±0.11, and 0.63±0.12 for the RI, and for the PI/RI, 2.62±0.70, 1.90±0.47, 2.54±0.67, and 1.82±0.41 respectively.The mean uterine artery PI, RI, and PI/RI decrease from 11 weeks + 0 days-11 weeks + 6 days to 13 weeks + 0 days-13 weeks + 6 days. They also decrease from pregnant patients with bilateral uterine artery notching to those without notching. The frequency of uterine artery notching decreases with increasing gestational age. Our results are similar to those in literature.
Keywords:	pregnancy, gestational age, uterine artery notching, Doppler indices, pulsatility index, resistivity index, preeclampsia, IUGR
References:	Akbaş M, Şen C, Calay Z. Correlation between First and Second Trimester Uterine Artery Doppler Velocimetry and Placental Bed Histopathology Int Sch Res Notices. 2014 Jul 13;2014 Alves JA, Silva BY, de Sousa PC, Maia SB, Costa Fida S. Reference range of uterine artery Doppler parameters between the 11th and 14th pregnancy weeks in a population sample from Northeast Brazil. Rev Bras Ginecol Obstet. 2013 Aug;35(8):357-62. Antonio Gadelha da Costa; Patricia Spara; Thiago de Oliveira Costa; William Ramos Tejo Neto Uterine arteries resistance and pulsatility indices at the first and second trimesters of normal pregnancies Radiol Bras. 2010 Mai/Jun;43(3):161–165 Dascau V, Gh. Furau, C. Furau, C. Onel, C. Stănescu, L. Tătaru, C. Ghib-Para, M. Puschita Uterine Artery Doppler Flow Indices in Pregnant Women During The 11 Weeks + 0 Days ind 13 Weeks + 6 Days Gestational Ages: A Study Of 118 Patients J Med Ar 2016; 19 (1), 37-41 Dascau V, Gh. Furau, C. Furau, C. Onel, C. Stănescu, L. Tătaru, C. Ghib-Para, C. Popescu , L. Pilat., M. Puschita Uterine Artery Doppler Flow Indices in Pregnant Women During The 11 Weeks + 0 Days ind 13 Weeks + 6 Days Gestational Ages: A Study Of 168 Patients; MAEDICA – a Journal of Clinical Medicine 2017 a; 12(1): 36-41 Daşcău Voicu, Furău Gheorghe, Furău Cristian, Onel Cristina, Stănescu Casiana, Tătaru Liliana, Popescu Cristina, Puşchiţa Maria Uterine Artery Doppler Flow Indices in Pregnant Women During the 11 Weeks + 0 Days and 13 Weeks + 6 Days Gestational Ages: a Study of 201 Patients; Proceedings 5th Congress of the Romanian Society of Ultrasound in Obstetrics and Gynecology, 2017 b, 213-218 Ferreira AE, Mauad Filho F, Abreu PS, Mauad FM, Araujo JuniorE, Martins WP. The reproducibility of first and second trimester uterine artery pulsatility index by transvaginal and transabdominal ultrasound. Ultrasound Obstet Gynecol 2015; 46: 546-52. [CrossRef]J Turk Ger Gynecol Assoc 2016; 17: 16-20 Ghulmiyyah L, Sibai B. Maternal mortality from pre-eclampsia/eclampsia. Semin Perinatol 2012;36:56-9. Gomez O, F. Figueras, J. M. Martinez, M. Del Rio, M. Palacio, E. Eixarch, B. Puerto, O. Coll, V. Cararach and J. A. Vanrell Sequential changes in uterine artery blood flow pattern between the first and second trimesters of gestation in relation to pregnancy outcome Ultrasound Obstet Gynecol 2006; 28: 802–808 Gómez O, F. Figueras, S. Fernández, M. Bennasar, J. M. Martínez, B. Puerto, E. Gratacós Reference ranges for uterine artery mean pulsatility index at 11–41 weeks of gestation Ultrasound Obst Gyn Volume 32, Issue 2, August 2008, 128–132 Khalil A., NicolaideS KH How to record uterine artery Doppler in the first trimester Ultrasound Obstet Gynecol 2013; 42: 478–479 Melchiorre K, K. Leslie, F. Prefumo, A. Bhide and B. Thilaganathan First-trimester uterine artery Doppler indices in the prediction of small-for-gestational age pregnancy and intrauterine growth restriction Ultrasound Obstet Gynecol 2009; 33: 524–529 Peixoto AB, Da Cunha Caldas TM, Tonni G, De Almeida Morelli P, Santos LD, Martins WP, Araujo Júnior E. Reference range for uterine artery Doppler pulsatility index using transvaginal ultrasound at 20-24w6d of gestation in a low-risk Brazilian population. J Turk Ger Gynecol Assoc. 2016 Jan 12;17(1):16-20. Poon LC, Syngelaki A, Akolekar R, Lai J, Nicolaides KH. Combined screening for preeclampsia and small for gestational age at 11–13weeks. Fetal Diagn Ther 2012 [Epub ahead of print]. Roberge S, Nicolaides KH, Demers S, Villa P, Bujold E. Prevention of perinatal death and adverse perinatal outcome using lowdose aspirin: a meta-analysis. Ultrasound Obstet Gynecol. 2013;41(5):491-9. Scandiuzzi RM, de Campos Prado CA, Araujo Júnior E, Duarte G, Quintana SM, da Silva Costa F, Tonni G, de Carvalho Cavalli R, Marcolin AC Maternal uterine artery Doppler in the first and second trimesters as screening method for hypertensive disorders and adverse perinatal outcomes in low-risk pregnancies Obstet Gynecol Sci 2016;59(5):347-356 Velauthar L, Plana MN, Kalidindi M, Zamora J, Thilaga¬nathan B, Illanes SE, et al. First-trimester uterine artery Doppler and adverse pregnancy outcome: a meta-analy¬sis involving 55,974 women. Ultrasound Obstet Gynecol 2014;43:500-7.
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Article Title:	UTERINE ARTERY DOPPLER FLOW INDICES FROM 11 TO 14 WEEKS GESTATIONAL AGE
Authors:	V. Daşcău1, Gh. Furău1, C. Furău1, Cristina Onel1, Casiana Stănescu2, Liliana Tătaru1, Cristina Ghib-Para3, Cristina Popescu4, Maria Puschita5
Affiliation:	1Department of Obstetrics and Gynecalogy, „Vasile Goldiş” Western University, Arad, Romania 2Department of Anatomy, „Vasile Goldiş” Western University, Arad, Romania 3Department of Haematology, „Vasile Goldiş” Western University, Arad, Romania 4Department of Life Sciences, „Vasile Goldiş” Western University, Arad, Romania 5Department of Internal Medicine, „Vasile Goldiş” Western University, Arad, Romania
Abstract:	Uterine artery Doppler flow screening studies during the 11th and 14th weeks of pregnancy have been shown to be important in the prediction and prevention of pregnancy complications preeclampsia and IUGR in pregnant women. Our study of the Doppler flow indices of the uterine arteries involves 216 patients examined in our clinic, with pregnancies ranging from 11 weeks + 0 days to 13 weeks + 6 days. There were 83 patients from 11 weeks + 0 days to 11 weeks + 6 days (38.43%), 61 from 12 weeks + 0 days to 12 weeks + 6 days (28.25%), and 72 from 13 weeks + 0 days to 13 weeks + 6 days (33.33%). The values of the Doppler indices were: PI 1.75±0.78, 1.89± 0.80, 1.75±0.80, and 1.57±0.70, RI 0.73±0.13, 0.75±0.13, 0.72±0.13, and 0.70±0.13, and PI/RI 2.31±0.71, 2.43±0.74, 2.32±0.70, and 2.16±0.65 for the entire group and for the three intervals respectively. There were 105 (48.61%), 37 (17.13%, with 21 cases or 55.76% on the right side), and 74 (34.26%) patients with bilateral, unilateral and absent uterine artery notching, respectively. The Doppler indices for the three aforementioned groups were: 2.11±0.77, 1.59±0.69, and 1.30±0.55 for the PI, 0.79±0.10, 0.71±0.13, and 0.65±0.14 for the RI, and 2.63±0.70, 2.18±0.64, and 1.92±0.50 for the PI/RI, respectively. The indices for the arteries with and without notching in all patients, as well as for the uterine arteries with and without notching in patients with unilateral notching, were 2.10±0.75, 1.27±0.53, 2.01±0.67, and 1.18±0.42 for the PI, 0.78±0.10, 0.65±0.13, 0.78±0.11, and 0.63±0.12 for the RI, and for the PI/RI, 2.62±0.70, 1.90±0.47, 2.54±0.67, and 1.82±0.41 respectively.The mean uterine artery PI, RI, and PI/RI decrease from 11 weeks + 0 days-11 weeks + 6 days to 13 weeks + 0 days-13 weeks + 6 days. They also decrease from pregnant patients with bilateral uterine artery notching to those without notching. The frequency of uterine artery notching decreases with increasing gestational age. Our results are similar to those in literature.
Keywords:	pregnancy, gestational age, uterine artery notching, Doppler indices, pulsatility index, resistivity index, preeclampsia, IUGR
References:	Akbaş M, Şen C, Calay Z. Correlation between First and Second Trimester Uterine Artery Doppler Velocimetry and Placental Bed Histopathology Int Sch Res Notices. 2014 Jul 13;2014 Alves JA, Silva BY, de Sousa PC, Maia SB, Costa Fida S. Reference range of uterine artery Doppler parameters between the 11th and 14th pregnancy weeks in a population sample from Northeast Brazil. Rev Bras Ginecol Obstet. 2013 Aug;35(8):357-62. Antonio Gadelha da Costa; Patricia Spara; Thiago de Oliveira Costa; William Ramos Tejo Neto Uterine arteries resistance and pulsatility indices at the first and second trimesters of normal pregnancies Radiol Bras. 2010 Mai/Jun;43(3):161–165 Dascau V, Gh. Furau, C. Furau, C. Onel, C. Stănescu, L. Tătaru, C. Ghib-Para, M. Puschita Uterine Artery Doppler Flow Indices in Pregnant Women During The 11 Weeks + 0 Days ind 13 Weeks + 6 Days Gestational Ages: A Study Of 118 Patients J Med Ar 2016; 19 (1), 37-41 Dascau V, Gh. Furau, C. Furau, C. Onel, C. Stănescu, L. Tătaru, C. Ghib-Para, C. Popescu , L. Pilat., M. Puschita Uterine Artery Doppler Flow Indices in Pregnant Women During The 11 Weeks + 0 Days ind 13 Weeks + 6 Days Gestational Ages: A Study Of 168 Patients; MAEDICA – a Journal of Clinical Medicine 2017 a; 12(1): 36-41 Daşcău Voicu, Furău Gheorghe, Furău Cristian, Onel Cristina, Stănescu Casiana, Tătaru Liliana, Popescu Cristina, Puşchiţa Maria Uterine Artery Doppler Flow Indices in Pregnant Women During the 11 Weeks + 0 Days and 13 Weeks + 6 Days Gestational Ages: a Study of 201 Patients; Proceedings 5th Congress of the Romanian Society of Ultrasound in Obstetrics and Gynecology, 2017 b, 213-218 Ferreira AE, Mauad Filho F, Abreu PS, Mauad FM, Araujo JuniorE, Martins WP. The reproducibility of first and second trimester uterine artery pulsatility index by transvaginal and transabdominal ultrasound. Ultrasound Obstet Gynecol 2015; 46: 546-52. [CrossRef]J Turk Ger Gynecol Assoc 2016; 17: 16-20 Ghulmiyyah L, Sibai B. Maternal mortality from pre-eclampsia/eclampsia. Semin Perinatol 2012;36:56-9. Gomez O, F. Figueras, J. M. Martinez, M. Del Rio, M. Palacio, E. Eixarch, B. Puerto, O. Coll, V. Cararach and J. A. Vanrell Sequential changes in uterine artery blood flow pattern between the first and second trimesters of gestation in relation to pregnancy outcome Ultrasound Obstet Gynecol 2006; 28: 802–808 Gómez O, F. Figueras, S. Fernández, M. Bennasar, J. M. Martínez, B. Puerto, E. Gratacós Reference ranges for uterine artery mean pulsatility index at 11–41 weeks of gestation Ultrasound Obst Gyn Volume 32, Issue 2, August 2008, 128–132 Khalil A., NicolaideS KH How to record uterine artery Doppler in the first trimester Ultrasound Obstet Gynecol 2013; 42: 478–479 Melchiorre K, K. Leslie, F. Prefumo, A. Bhide and B. Thilaganathan First-trimester uterine artery Doppler indices in the prediction of small-for-gestational age pregnancy and intrauterine growth restriction Ultrasound Obstet Gynecol 2009; 33: 524–529 Peixoto AB, Da Cunha Caldas TM, Tonni G, De Almeida Morelli P, Santos LD, Martins WP, Araujo Júnior E. Reference range for uterine artery Doppler pulsatility index using transvaginal ultrasound at 20-24w6d of gestation in a low-risk Brazilian population. J Turk Ger Gynecol Assoc. 2016 Jan 12;17(1):16-20. Poon LC, Syngelaki A, Akolekar R, Lai J, Nicolaides KH. Combined screening for preeclampsia and small for gestational age at 11–13weeks. Fetal Diagn Ther 2012 [Epub ahead of print]. Roberge S, Nicolaides KH, Demers S, Villa P, Bujold E. Prevention of perinatal death and adverse perinatal outcome using lowdose aspirin: a meta-analysis. Ultrasound Obstet Gynecol. 2013;41(5):491-9. Scandiuzzi RM, de Campos Prado CA, Araujo Júnior E, Duarte G, Quintana SM, da Silva Costa F, Tonni G, de Carvalho Cavalli R, Marcolin AC Maternal uterine artery Doppler in the first and second trimesters as screening method for hypertensive disorders and adverse perinatal outcomes in low-risk pregnancies Obstet Gynecol Sci 2016;59(5):347-356 Velauthar L, Plana MN, Kalidindi M, Zamora J, Thilaga¬nathan B, Illanes SE, et al. First-trimester uterine artery Doppler and adverse pregnancy outcome: a meta-analy¬sis involving 55,974 women. Ultrasound Obstet Gynecol 2014;43:500-7.
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