UTERINE ARTERY DOPPLER FLOW INDICES IN PREGNANT WOMEN DURING THE 21 WEEKS + 0 DAYS AND 23 WEEKS + 6 DAYS GESTATIONAL AGES: A STUDY OF 115 PATIENTS

UTERINE ARTERY DOPPLER FLOW INDICES IN PREGNANT WOMEN DURING THE 21 WEEKS + 0 DAYS AND 23 WEEKS + 6 DAYS GESTATIONAL AGES: A STUDY OF 115 PATIENTS

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Title:	UTERINE ARTERY DOPPLER FLOW INDICES IN PREGNANT WOMEN DURING THE 21 WEEKS + 0 DAYS AND 23 WEEKS + 6 DAYS GESTATIONAL AGES: A STUDY OF 115 PATIENTS
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Article_Title:	UTERINE ARTERY DOPPLER FLOW INDICES IN PREGNANT WOMEN DURING THE 21 WEEKS + 0 DAYS AND 23 WEEKS + 6 DAYS GESTATIONAL AGES: A STUDY OF 115 PATIENTS
Authors:	V. Dascau1, Gh. Furau1, C. Furau1, Cristina Onel1, Casiana Stănescu2, Liliana Tătaru1, Cristina Ghib-Para3, Luminiţa Pilat4, 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 Physiology, „Vasile Goldiş” Western University, Arad, Romania 5Department of Internal Medicine, „Vasile Goldiş” Western University, Arad, Romania
Abstract:	Uterine artery Doppler flow studies during the 21st and 24th weeks of pregnancy are important in the prediction of preeclampsia and IUGR in pregnant women and also in the prevention thereof. Our study of the Doppler flow indices of the uterine arteries involves 115 patients examined in our clinic, with pregnancies ranging from 21 weeks + 0 days to 23 weeks + 6 days. There were 33 patients from 21 weeks + 0 days to 21 weeks + 6 days (28.70%), 41 from 22 weeks + 0 days to 22 weeks + 6 days (35.65%), and 41 from 23 weeks + 0 days to 23 weeks + 6 days (35.65%). The values of the Doppler indices were: PI 1.05±0.46, 1.01±0.36, 1.08±0.62, and 1.05±0.33 and RI 0.58±0.11, 0.57±0.11, 0.57±0.13, and 0.59±0.09 for the entire group and for the three intervals respectively. There were 10 (8.70%), 14 (12.17%, with 9 cases or 71.43% on the left side), and 91 (79.13%) patients with bilateral, unilateral and absent uterine artery notching, respectively. The Doppler indices for the three aforementioned groups were: 1.67±0.85, 1.15±0.49, and 0.97±0.33 for the PI and 0.70±0.12, 0.60±0.12, and 0.56±0.10 for the 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 1.53±0.76, 0.97±0.32, 1.32±0.57, and 0.98±0.33 for the PI and 0.67±0.13, 0.56±0.10, 0.64±0.14, and 0.57±0.10 for the RI, respectively. The mean uterine artery PI and RI vary from 21 weeks + 0 days-21 weeks + 6 days to 23 weeks + 0 days-23 weeks + 6 days. They decrease from pregnant patients with bilateral uterine artery notching to those without notching. The frequency of bilateral uterine artery notching increases in our study 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:	A. T. Papageorghiou, C. K. H. Yu, R. Bindra, G. Pandis and K. H. Nicolaides Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation Ultrasound Obstet Gynecol 2001; 18: 441–449 Albaiges G, Missfelder-Lobos H, Lees C, Parra M, Nicolaides KH. One-stage screening for pregnancy complications by color Doppler assessment of the uterine arteries at 23 weeks’ gestation. Obstet Gynecol 2000;in press Arduini D, Rizzo G. Normal flow patterns during pregnancy. In A Critical Appraisal of Fetal Surveillance, Van Geijn HP, Copray FJA (eds). Excerpta Medica: Amsterdam, 1994; 461–469. Bewley S, Cooper D, Campbell S. Doppler investigation of uteroplacental blood flow resistance in the second trimester: a screening study for pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol 1991;98:871–9 Borges Peixoto A, Rodrigues Da Cunha Caldas TM, Tonni G, De Almeida Morelli P, D’amico Santos L, Martins WP, Araujo Júnior E Reference range for uterine artery Doppler pulsatilit index using transvaginal ultrasound at 20–24w6d of gestation in a low-risk Brazilian population, J Turk Ger Gynecol Assoc. 2016; 17(1): 16–20. Bower S, Schuchter K, Campbell S. Doppler ultrasound screening as part of routine antenatal scanning: prediction of pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol 1993;100:989–94 Campbell S, Diaz-Recasens J, Griffin DR, Cohen-Overbeek TE, Pearce JM, Wilson K, Teague MJ. New Doppler technique for assessing uteroplacental blood flow. Lancet 1983; i: 675–677. Chan FY, Pun TC, Lam C, Khoo J, Lee CP, Lam YH. Pregnancy screening by uterine artery Doppler velocimetry – which criterion performs best? Obstet Gynecol 1995;85:596–602 Chappell L, Bewley S. Pre-eclamptic toxaemia: the role of uterine artery Doppler. Br J Obstet Gynaecol 1998; 105: 379–382. Davies JA, Gallivan S, Spencer JAD. Randomised controlled trial of Doppler ultrasound screening of placental perfusion during pregnancy. Lancet 1992;340:1299–303 Frusca T, Soregaroli M, Valcamonico A, Guandalini F, Danti L. Doppler velocimetry of the uterine arteries in nulliparous women. Early Hum Dev 1997;48:177–85 G. Albaiges, H. Missfelder-Lobos, M. Parra, C. Lees, D. Cooper and K. H. Nicolaides Comparison of color Doppler uterine artery indices in a population at high risk for adverse outcome at 24 weeks’ gestation Ultrasound Obstet Gynecol 2003; 21: 170–173 Harrington K, Cooper D, Lees C, Hecher K, Campbell S. Doppler ultrasound of the uterine arteries: the importance of bilateral notching in the prediction of pre-eclampsia, placental abruption or delivery of a small-for-gestational-age baby. Ultrasound Obstet Gynecol 1996;7:182–8 Kurdi W, Campbell S, Aquilina J, England P, Harrington K. The role of color Doppler imaging of the uterine arteries at 20 weeks’ gestation in stratifying antenatal care. Ultrasound Obstet Gynecol 1998;12:339–45 Maciel Scandiuzzi R, 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 Sep;59(5):347-356. North RA, Ferrier C, Long D, Townend K, Kincaid-Smith P. Uterine artery Doppler flow velocity waveforms in the second trimester for the prediction of preeclampsia and fetal growth retardation. Obstet Gynecol 1994;83:378–86 O. Gomez, 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 O. Gomez, F. Figueras, S. Fernandez, M. Bennasar, J. M. Martinez, B. Puerto and E. Gratacos Reference ranges for uterine artery mean pulsatility index at 11–41 weeks of gestation Ultrasound Obstet Gynecol 2008; 32: 128–132 Valensise H, Bezzeccheri V, Rizzo G, Tranquilli AL, Garzetti GG, Romanini C. Doppler velocimetry of the uterine artery as a screening test for gestational hypertension. Ultrasound Obstet Gynecol 1993;3:18–22 Valensise H. Uterine artery Doppler velocimetry as a screening test: where we are and where we go. Ultrasound Obstet Gynecol 1998; 12: 81–83. Zimmermann P, Eirio V, Koskinen J, Kujansuu E, Ranta T. Doppler assessment of the uterine and uteroplacental circulation in the second trimester in pregnancies at high risk for pre-eclampsia and/or intrauterine growth retardation: comparison and correlation between different Doppler parameters. Ultrasound Obstet Gynecol 1997;9:330–8
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Article Title:	UTERINE ARTERY DOPPLER FLOW INDICES IN PREGNANT WOMEN DURING THE 21 WEEKS + 0 DAYS AND 23 WEEKS + 6 DAYS GESTATIONAL AGES: A STUDY OF 115 PATIENTS
Authors:	V. Dascau1, Gh. Furau1, C. Furau1, Cristina Onel1, Casiana Stănescu2, Liliana Tătaru1, Cristina Ghib-Para3, Luminiţa Pilat4, 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 Physiology, „Vasile Goldiş” Western University, Arad, Romania 5Department of Internal Medicine, „Vasile Goldiş” Western University, Arad, Romania
Abstract:	Uterine artery Doppler flow studies during the 21st and 24th weeks of pregnancy are important in the prediction of preeclampsia and IUGR in pregnant women and also in the prevention thereof. Our study of the Doppler flow indices of the uterine arteries involves 115 patients examined in our clinic, with pregnancies ranging from 21 weeks + 0 days to 23 weeks + 6 days. There were 33 patients from 21 weeks + 0 days to 21 weeks + 6 days (28.70%), 41 from 22 weeks + 0 days to 22 weeks + 6 days (35.65%), and 41 from 23 weeks + 0 days to 23 weeks + 6 days (35.65%). The values of the Doppler indices were: PI 1.05±0.46, 1.01±0.36, 1.08±0.62, and 1.05±0.33 and RI 0.58±0.11, 0.57±0.11, 0.57±0.13, and 0.59±0.09 for the entire group and for the three intervals respectively. There were 10 (8.70%), 14 (12.17%, with 9 cases or 71.43% on the left side), and 91 (79.13%) patients with bilateral, unilateral and absent uterine artery notching, respectively. The Doppler indices for the three aforementioned groups were: 1.67±0.85, 1.15±0.49, and 0.97±0.33 for the PI and 0.70±0.12, 0.60±0.12, and 0.56±0.10 for the 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 1.53±0.76, 0.97±0.32, 1.32±0.57, and 0.98±0.33 for the PI and 0.67±0.13, 0.56±0.10, 0.64±0.14, and 0.57±0.10 for the RI, respectively. The mean uterine artery PI and RI vary from 21 weeks + 0 days-21 weeks + 6 days to 23 weeks + 0 days-23 weeks + 6 days. They decrease from pregnant patients with bilateral uterine artery notching to those without notching. The frequency of bilateral uterine artery notching increases in our study 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:	A. T. Papageorghiou, C. K. H. Yu, R. Bindra, G. Pandis and K. H. Nicolaides Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation Ultrasound Obstet Gynecol 2001; 18: 441–449 Albaiges G, Missfelder-Lobos H, Lees C, Parra M, Nicolaides KH. One-stage screening for pregnancy complications by color Doppler assessment of the uterine arteries at 23 weeks’ gestation. Obstet Gynecol 2000;in press Arduini D, Rizzo G. Normal flow patterns during pregnancy. In A Critical Appraisal of Fetal Surveillance, Van Geijn HP, Copray FJA (eds). Excerpta Medica: Amsterdam, 1994; 461–469. Bewley S, Cooper D, Campbell S. Doppler investigation of uteroplacental blood flow resistance in the second trimester: a screening study for pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol 1991;98:871–9 Borges Peixoto A, Rodrigues Da Cunha Caldas TM, Tonni G, De Almeida Morelli P, D’amico Santos L, Martins WP, Araujo Júnior E Reference range for uterine artery Doppler pulsatilit index using transvaginal ultrasound at 20–24w6d of gestation in a low-risk Brazilian population, J Turk Ger Gynecol Assoc. 2016; 17(1): 16–20. Bower S, Schuchter K, Campbell S. Doppler ultrasound screening as part of routine antenatal scanning: prediction of pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol 1993;100:989–94 Campbell S, Diaz-Recasens J, Griffin DR, Cohen-Overbeek TE, Pearce JM, Wilson K, Teague MJ. New Doppler technique for assessing uteroplacental blood flow. Lancet 1983; i: 675–677. Chan FY, Pun TC, Lam C, Khoo J, Lee CP, Lam YH. Pregnancy screening by uterine artery Doppler velocimetry – which criterion performs best? Obstet Gynecol 1995;85:596–602 Chappell L, Bewley S. Pre-eclamptic toxaemia: the role of uterine artery Doppler. Br J Obstet Gynaecol 1998; 105: 379–382. Davies JA, Gallivan S, Spencer JAD. Randomised controlled trial of Doppler ultrasound screening of placental perfusion during pregnancy. Lancet 1992;340:1299–303 Frusca T, Soregaroli M, Valcamonico A, Guandalini F, Danti L. Doppler velocimetry of the uterine arteries in nulliparous women. Early Hum Dev 1997;48:177–85 G. Albaiges, H. Missfelder-Lobos, M. Parra, C. Lees, D. Cooper and K. H. Nicolaides Comparison of color Doppler uterine artery indices in a population at high risk for adverse outcome at 24 weeks’ gestation Ultrasound Obstet Gynecol 2003; 21: 170–173 Harrington K, Cooper D, Lees C, Hecher K, Campbell S. Doppler ultrasound of the uterine arteries: the importance of bilateral notching in the prediction of pre-eclampsia, placental abruption or delivery of a small-for-gestational-age baby. Ultrasound Obstet Gynecol 1996;7:182–8 Kurdi W, Campbell S, Aquilina J, England P, Harrington K. The role of color Doppler imaging of the uterine arteries at 20 weeks’ gestation in stratifying antenatal care. Ultrasound Obstet Gynecol 1998;12:339–45 Maciel Scandiuzzi R, 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 Sep;59(5):347-356. North RA, Ferrier C, Long D, Townend K, Kincaid-Smith P. Uterine artery Doppler flow velocity waveforms in the second trimester for the prediction of preeclampsia and fetal growth retardation. Obstet Gynecol 1994;83:378–86 O. Gomez, 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 O. Gomez, F. Figueras, S. Fernandez, M. Bennasar, J. M. Martinez, B. Puerto and E. Gratacos Reference ranges for uterine artery mean pulsatility index at 11–41 weeks of gestation Ultrasound Obstet Gynecol 2008; 32: 128–132 Valensise H, Bezzeccheri V, Rizzo G, Tranquilli AL, Garzetti GG, Romanini C. Doppler velocimetry of the uterine artery as a screening test for gestational hypertension. Ultrasound Obstet Gynecol 1993;3:18–22 Valensise H. Uterine artery Doppler velocimetry as a screening test: where we are and where we go. Ultrasound Obstet Gynecol 1998; 12: 81–83. Zimmermann P, Eirio V, Koskinen J, Kujansuu E, Ranta T. Doppler assessment of the uterine and uteroplacental circulation in the second trimester in pregnancies at high risk for pre-eclampsia and/or intrauterine growth retardation: comparison and correlation between different Doppler parameters. Ultrasound Obstet Gynecol 1997;9:330–8
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