CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2018; 40(05): 287-293
DOI: 10.1055/s-0038-1660777
Review Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction

Doppler das artérias uterinas no rastreamento para pré-eclâmpsia e restrição do crescimento fetal
Marianna Amaral Pedroso
1   Hospital Mater Dei, Belo Horizonte, MG, Brazil
,
Kirsten Rebecca Palmer
2   Department of Obstetrics and Gynecology, Monash University, Melbourne, Australia
,
Ryan James Hodges
2   Department of Obstetrics and Gynecology, Monash University, Melbourne, Australia
,
Fabricio da Silva Costa
2   Department of Obstetrics and Gynecology, Monash University, Melbourne, Australia
,
Daniel Lorber Rolnik
2   Department of Obstetrics and Gynecology, Monash University, Melbourne, Australia
› Author Affiliations
Further Information

Publication History

07 December 2017

03 March 2018

Publication Date:
18 June 2018 (online)

Abstract

Objective To perform a comprehensive review of the current evidence on the role of uterine artery Doppler, isolated or in combination with other markers, in screening for preeclampsia (PE) and fetal growth restriction (FGR) in the general population. The review included recently published large cohort studies and randomized trials.

Methods A search of the literature was conducted using Medline, PubMed, MeSH and ScienceDirect. Combinations of the search terms “preeclampsia,” “screening,” “prediction,” “Doppler,” “Doppler velocimetry,” “fetal growth restriction,” “small for gestational age” and “uterine artery” were used. Articles in English (excluding reviews) reporting the use of uterine artery Doppler in screening for PE and FGR were included.

Results Thirty articles were included. As a single predictor, uterine artery Doppler detects less than 50% of the cases of PE and no more than 40% of the pregnancies affected by FGR. Logistic regression-based models that allow calculation of individual risk based on the combination of multiple markers, in turn, is able to detect ∼ 75% of the cases of preterm PE and 55% of the pregnancies resulting in small for gestational age infants.

Conclusion The use of uterine artery Doppler as a single predictive test for PE and FGR has poor accuracy. However, its combined use in predictive models is promising, being more accurate in detecting preterm PE than FGR.

Resumo

Objetivo Realizar revisão da literatura científica acerca do uso do Doppler das artérias uterinas, de forma isolada ou em combinação com outros marcadores, no rastreamento para pré-eclâmpsia (PE) e restrição do crescimento fetal (RCF) na população geral. A revisão incluiu estudos de coorte e ensaios clínicos randomizados recentemente publicados.

Métodos Realizou-se uma pesquisa da literatura nas bases de dados Medline, PubMed, MeSH e ScienceDirect. Diferentes combinações dos termos “preeclampsia,” “screening,” “prediction,” “Doppler,” “Doppler velocimetry,” “fetal growth restriction,” “small for gestational age” e “uterine artery” foram utilizadas. Artigos em inglês, (excluindo-se artigos de revisão) em que o Doppler das artérias uterinas é reportado como ferramenta no rastreamento para PE e RCF foram incluídos.

Resultados Trinta artigos foram incluídos. Como teste preditivo isolado, o Doppler das artérias uterinas tem sensibilidade inferior a 50% na detecção de casos de PE e inferior a 40% para identificação de gestações afetadas por RCF. Modelos matemáticos preditivos baseados em equações de regressão logística que permitem o cálculo de risco individual, por sua vez, são mais promissores, permitindo a detecção de 75% dos casos de PE pré-termo, e 55% das gestações que resultarão em parto de recém-nascidos pequenos para a idade gestacional.

Conclusão O uso do Doppler das artérias uterinas tem baixa acurácia na identificação de gestações afetadas por PE e RCF. No entanto, seu uso combinado com outros marcadores é mais promissor, apresentando maior acurácia para detecção de PE do que para RCF.

 
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