The role of first trimester uterine artery Doppler in the prediction of preeclampsia

Objective: Our aim was to assess the relationship between firsttrimester uterine artery pulsatility index (UtA PI) and the development of preeclampsia. Methods: Uterine artery pulsatility index measurements were recorded in 412 nulliparous women with singleton pregnancies at 11+0 to 13+6 weeks of gestation. Predicted detection rates for preeclampsia and early preeclampsia were calculated for threshold UtA PI values. Results: Preeclampsia and early preeclampsia were present 9.4% and 3.1% of pregnancies respectively. Mean UtA PI was 2.5±0.9 in group who developed preeclampsia and 1.7±0.5 in non-preeclamptic group (p<0.001). Receiver-operating characteristics (ROC) curve analysis for prediction of preeclampsia and early preeclampsia for UtA PI, the area under curve was 0.79 and 0.83, respectively. In predicting preeclampsia, the sensitivity, positive prediction value and negative prediction value of UtA PI at 2.56 threshold value for 5% false positivity were found as 45.5%, 50% and 94.4%, respectively. The sensitivity, specificity, positive prediction value and negative prediction value of 2.56 threshold value of uterine artery pulsatility index in early-onset preeclampsia prediction were found as 63.6%, 93.3%, 23.3% and 98.8%, respectively. The sensitivity, positive prediction value and negative prediction value of UtA PI at 2.72 threshold value for 5% false positivity in predicting early-onset preeclampsia were found as 45.5%, 23.8% and 98.2%, respectively. The sensitivity, specificity, positive prediction value and negative prediction value at 2.72 threshold value of uterine artery pulsatility index in predicting preeclampsia were found as 33.3%, 96.9%, 52.4% and 93.4%, respectively. Conclusion: Uterine artery Doppler at 11-14 weeks of gestation identifies about 65% of women who develop early preeclampsia.