Normative Values of Uterine Artery Doppler Pulsatility Index using Transvaginal Ultrasound in Women between 18-24+6 Weeks of Gestation at Rajavithi Hospital
Article Sidebar
Published:
Jul 1, 2021
Keywords:
uterine artery pulsatility index normative values second trimester
Main Article Content
Abstract
Objectives: To establish the normative values of uterine artery Doppler pulsatility index (UtA-PI) obtained using transvaginal ultrasound in an unselected population at 18-24+6 weeks of gestation and to ascertain the relationship between UtA-PI and gestational age.
Materials and Methods: A prospective cross-sectional study was conducted in Rajavithi Hospital from December 2018 to June 2019. The mean UtA-PI was calculated using color Doppler ultrasound with uterine artery gated at the level of the internal os. Mean UtA-PI in relation to gestational age (GA) was reported, and linear regression was used to calculate the 5th, 10th, 50th, 90th and 95th percentiles of the UtA-PI.
Results: A total of 185 singleton pregnancies were enrolled in this study. Nineteen cases (10.2%) were excluded, leaving a total of 166 cases to be analyzed. The mean UtA-PI ranged from 1.19 at 18 weeks to 0.81 at 24 weeks of gestation. The best-fit curve of mean UtA-PI as a function of GA was a linear function: mean UtA-PI = 2.33-0.0634*GA (R2 = 0.271).
Conclusion: Normative values for the mean UtA-PI at 18-24+6 weeks of gestation using transvaginal ultrasound were established. A decrease in mean UtA-PI with advancing GA was observed, and the prevalence of uterine artery notching in the study was 7.57%.
Article Details
How to Cite
(1)
Songsathaporn, L.; Puttanavijarn, L.; Sudjai, D. Normative Values of Uterine Artery Doppler Pulsatility Index Using Transvaginal Ultrasound in Women Between 18-24+6 Weeks of Gestation at Rajavithi Hospital. Thai J Obstet Gynaecol 2021, 29, 227-235.
Section
Original Article
References
1. Ferreira AE, Mauad Filho F, Abreu PS, reira AE, Mauad Filho F, Abreu PS, Mauad FM, Araujo Junior E, 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
2. Papageorghiou AT, Yu CKH, Cicero S, Bower S, Nicolaides KH. Second-trimester uterine artery Doppler screening in unselected populations: a review. J Matern Fetal Neonatal Med 2002;12:78–88.
3. Steer CV, Williams J, Zaidi J, Campbell S, Tan SL. Intraobserver, interobserver, interultrasound transducer and intercycle variation in colour Doppler assessment of uterine artery impedance. Hum Reprod 1995;10:479–48.
4. Jaffa AJ, Weissman A, Har-Toov J, Shoham Z, Peyser RM. Flow velocity waveforms of the uterine artery in pregnancy: transvaginal versus transabdominal approach. Gynecol Obstet Invest 1995;40:80–3.
5. Marchi L, Zwertbroek E, Snelder J, Kloosterman M, Bilardo C.M. Intra and Inter-Observer Reporducibility and Generalizability of First Trimester Uterine Artery Pulsatility Index by Transabdominal and Transvaginal Ultrasound. Prenatal Diagnosis 2016;36:1261-9.b
6. The Fetal Medicine Foundation. Preeclampsia screening. London (United Kingdom): FMF; 2019. Available at: https://courses.fetalmedicine.com/fmf/show/820?locale=en. Retrieved July 1,2019.
7. Schulman H, Fleischer A, Farmakides G, Bracero L, Rochelson B, Grunfeld L. Development of uterine artery compliance in pregnancy as detected by Doppler ultrasound. Am J Obstet Gynecol 1986;155:1031–6.
8. Society for Maternal-Fetal Medicine Publications Committee, with assistance of Vincenzo Berghella. Progesterone and preterm birth prevention: translating clinical trials data intoclinical practice. Am J Obstet Gynecol 2012;206:376-86.
9. Society for Maternal-Fetal Medicine (SMFM) Publications Committee. The role of routine cervical length screening in selected high- and low risk women for preterm birth prevention. Am J Obstet Gynecol 2016;215:B2-7.
10. Wayne WD. Biostatistics: A foundation of analysis in the health sciences. 6th ed. New York: John Wiley and Sons; 1995
11. Pijnenborg R, Bland JM, Robertson WB, Brosens I. Uteroplacental arterial changes related to interstitial trophoblast migration in early hyman pregnancy. Placenta 1983;4:387-413.
12. Papageorghiou AT, Yu CKH, Bindra R, Pandis G, Nicolaides KH. Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation. Ultrasound Obstet Gynecol 2001;18:441–9.
13. Yu CK, Tomruk S, Tuncay YA, Naki M, Sezginsoy S, Zemheri E, et al. The relation of increased uterine artery blood flow resistance and impaired trophoblast invasion in pre-eclamptic pregnancies. Arch Gynecol Obstet 2005;272:283-8.
14. Phupong V, Dejthevaporn T. Predicting Risks of Preeclampsia and Small for Gestational Age infant by Uterine Artery Doppler. Hypertension in Pregnancy, 27:4,387-95.
15. Sritippayawan S, Phupong V. Risk Assessment of Preeclampsia in Advanced Maternal Age by Uterine Arteries Doppler at 17-21 Weeks of Gestation. J Med Assoc Thai 2007;90(7):1281-6
16. Guzin K, Tomruk S, Tuncay YA et al. The relation of increased uterine artery blood flow resistance and impaired trophoblast invasion in pre-eclamptic pregnancies. Arch Gynecol Obstet 2005;272:283-8.
17. Gross K, Alba S, Glass TR, Schellenberg JA, Obrist B. Timing of antenatal care for adolescent and adult pregnant women in south- eastern Tanzania. BMC Pregnancy Childbirth 2012;12:16-28.
18. Muhwava LS, Morojele N, London L. Psychosocial factors associated with early initiation and frequency of antenatal care (ANC) visits in a rural and urban setting in South Africa: a cross- sectional survey. BMC Pregnancy Childbirth 2016;16:18.
19. Turysaiima M, Tugume R, Openy A, Ahairwomugisha E, Opio R, Ntunguka M, et al. Determinants of first antenatal care visit by pregnant women at Community Based Education, Research and Service Sites in Northern Uganda. East Afr Med J 2014;91:317–22.
20. Gallo DM, Wright D, Casanova C, Campanero M, Nicolaides KH. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 19-24 weeks’ gestation. Am J Obstet Gynecol 2016;214:619.e1-17.
21. Litwinska M., Wright D., Efeturk T, Ceccacci I., Nicolaides KH. Proposed clinical management of pregnancies after combined screening for pre-eclampsia at 19-24 weeks’ gestation. Ultrasound Obstet Gynecol 2017;50:367-72.
22. ACOG Committee Opinion No.743 Low-Dose Aspirin Use During Pregnancy. Obstet Gynecol 2018;132:e44-52.
23. Peixoto AB, Caldas TMRD, Tonni G, Morelli PDA, Santos LDS, Martins WP, et al. Reference range for uterine artery Doppler pulsatility index using transvaginal ultrasound at 20-24w6d of gestation in a low-risk Brazillian population. J Turk Ger Gynecol Assoc 2016; 17:16-20.
24. Gómez O, Figueras F, Fernández S, Bennasar M, Martínez JM, Puerto B, et al. Reference ranges for uterine artery mean pulsatility index at 11–41 weeks of gestation. Ultrasound Obstet Gynecol 2008;32:128-32.
25. Takahashi K, Ohkuchi A, Hirashima C, Matsubara S, Suzuki M. Establishing reference values for mean notch depth index, pulsatility index and resistance index in the uterine artery at 16-23 weeks’ gestation. J Obstet Gynaecol Res. 2012;38:1275-85.
26. Nanthakomon T, Chanthasenanont A, Somprasit C. Uterine artery Doppler flow in advanced maternal age at 17-24 weeks of gestation. Thammasat Medical Journal. 2010;10:271-81.
2. Papageorghiou AT, Yu CKH, Cicero S, Bower S, Nicolaides KH. Second-trimester uterine artery Doppler screening in unselected populations: a review. J Matern Fetal Neonatal Med 2002;12:78–88.
3. Steer CV, Williams J, Zaidi J, Campbell S, Tan SL. Intraobserver, interobserver, interultrasound transducer and intercycle variation in colour Doppler assessment of uterine artery impedance. Hum Reprod 1995;10:479–48.
4. Jaffa AJ, Weissman A, Har-Toov J, Shoham Z, Peyser RM. Flow velocity waveforms of the uterine artery in pregnancy: transvaginal versus transabdominal approach. Gynecol Obstet Invest 1995;40:80–3.
5. Marchi L, Zwertbroek E, Snelder J, Kloosterman M, Bilardo C.M. Intra and Inter-Observer Reporducibility and Generalizability of First Trimester Uterine Artery Pulsatility Index by Transabdominal and Transvaginal Ultrasound. Prenatal Diagnosis 2016;36:1261-9.b
6. The Fetal Medicine Foundation. Preeclampsia screening. London (United Kingdom): FMF; 2019. Available at: https://courses.fetalmedicine.com/fmf/show/820?locale=en. Retrieved July 1,2019.
7. Schulman H, Fleischer A, Farmakides G, Bracero L, Rochelson B, Grunfeld L. Development of uterine artery compliance in pregnancy as detected by Doppler ultrasound. Am J Obstet Gynecol 1986;155:1031–6.
8. Society for Maternal-Fetal Medicine Publications Committee, with assistance of Vincenzo Berghella. Progesterone and preterm birth prevention: translating clinical trials data intoclinical practice. Am J Obstet Gynecol 2012;206:376-86.
9. Society for Maternal-Fetal Medicine (SMFM) Publications Committee. The role of routine cervical length screening in selected high- and low risk women for preterm birth prevention. Am J Obstet Gynecol 2016;215:B2-7.
10. Wayne WD. Biostatistics: A foundation of analysis in the health sciences. 6th ed. New York: John Wiley and Sons; 1995
11. Pijnenborg R, Bland JM, Robertson WB, Brosens I. Uteroplacental arterial changes related to interstitial trophoblast migration in early hyman pregnancy. Placenta 1983;4:387-413.
12. Papageorghiou AT, Yu CKH, Bindra R, Pandis G, Nicolaides KH. Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation. Ultrasound Obstet Gynecol 2001;18:441–9.
13. Yu CK, Tomruk S, Tuncay YA, Naki M, Sezginsoy S, Zemheri E, et al. The relation of increased uterine artery blood flow resistance and impaired trophoblast invasion in pre-eclamptic pregnancies. Arch Gynecol Obstet 2005;272:283-8.
14. Phupong V, Dejthevaporn T. Predicting Risks of Preeclampsia and Small for Gestational Age infant by Uterine Artery Doppler. Hypertension in Pregnancy, 27:4,387-95.
15. Sritippayawan S, Phupong V. Risk Assessment of Preeclampsia in Advanced Maternal Age by Uterine Arteries Doppler at 17-21 Weeks of Gestation. J Med Assoc Thai 2007;90(7):1281-6
16. Guzin K, Tomruk S, Tuncay YA et al. The relation of increased uterine artery blood flow resistance and impaired trophoblast invasion in pre-eclamptic pregnancies. Arch Gynecol Obstet 2005;272:283-8.
17. Gross K, Alba S, Glass TR, Schellenberg JA, Obrist B. Timing of antenatal care for adolescent and adult pregnant women in south- eastern Tanzania. BMC Pregnancy Childbirth 2012;12:16-28.
18. Muhwava LS, Morojele N, London L. Psychosocial factors associated with early initiation and frequency of antenatal care (ANC) visits in a rural and urban setting in South Africa: a cross- sectional survey. BMC Pregnancy Childbirth 2016;16:18.
19. Turysaiima M, Tugume R, Openy A, Ahairwomugisha E, Opio R, Ntunguka M, et al. Determinants of first antenatal care visit by pregnant women at Community Based Education, Research and Service Sites in Northern Uganda. East Afr Med J 2014;91:317–22.
20. Gallo DM, Wright D, Casanova C, Campanero M, Nicolaides KH. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 19-24 weeks’ gestation. Am J Obstet Gynecol 2016;214:619.e1-17.
21. Litwinska M., Wright D., Efeturk T, Ceccacci I., Nicolaides KH. Proposed clinical management of pregnancies after combined screening for pre-eclampsia at 19-24 weeks’ gestation. Ultrasound Obstet Gynecol 2017;50:367-72.
22. ACOG Committee Opinion No.743 Low-Dose Aspirin Use During Pregnancy. Obstet Gynecol 2018;132:e44-52.
23. Peixoto AB, Caldas TMRD, Tonni G, Morelli PDA, Santos LDS, Martins WP, et al. Reference range for uterine artery Doppler pulsatility index using transvaginal ultrasound at 20-24w6d of gestation in a low-risk Brazillian population. J Turk Ger Gynecol Assoc 2016; 17:16-20.
24. Gómez O, Figueras F, Fernández S, Bennasar M, Martínez JM, Puerto B, et al. Reference ranges for uterine artery mean pulsatility index at 11–41 weeks of gestation. Ultrasound Obstet Gynecol 2008;32:128-32.
25. Takahashi K, Ohkuchi A, Hirashima C, Matsubara S, Suzuki M. Establishing reference values for mean notch depth index, pulsatility index and resistance index in the uterine artery at 16-23 weeks’ gestation. J Obstet Gynaecol Res. 2012;38:1275-85.
26. Nanthakomon T, Chanthasenanont A, Somprasit C. Uterine artery Doppler flow in advanced maternal age at 17-24 weeks of gestation. Thammasat Medical Journal. 2010;10:271-81.