Second trimester uterine artery Doppler ultrasound as a screening test for adverse pregnancy outcome

One main goal of antenatal care is to improve the outcome of pregnancy in terms of perinatal morbidity and perinatal mortality by identifying women at risk of complications such as preeclampsia, intrauterine growth retardation, placental abruption and intrauterine death. The association between pre-eclampsia, intrauterine growth retardation and increased uterine artery resistance measured by Doppler ultrasound has been described and subsequently color Doppler waveform analysis of the uterine arteries has been used as a screening test for adverse pregnancy outcome. The results were conflicting and often disappointing due to differences in gestational age at the time of examination in the selected study populations and due to a lack of standardized analysis of the uterine artery waveform. In low-risk populations uterine artery Doppler waveform analysis remains a test with relatively low positive predictive values reflecting the low prevalence of pregnancy complications in an unselected population. Patients with bilateral notching at 24 weeks of gestation represent a group at risk for preeclampsia, intrauterine growth retardation and adverse pregnancy outcome.