Uterine Artery Doppler Ultrasound for Predicting Preeclampsia During Pregnancy: A Meta-analysis

Abstract

Abstract Background Accurate prediction of preeclampsia can improve maternal outcomes. However, the utility of uterine artery Doppler imaging in the prediction of preeclampsia remains unclear. To investigate the accuracy of uterine artery Doppler ultrasound parameters in predicting preeclampsia during pregnancy. Methods We searched databases for studies using uterine artery Doppler imaging to predict preeclampsia from inception to March 23, 2023. The main outcome was preeclampsia. We assessed study bias using QUADAS-2. Results Of 40 studies, 19 used the pulsatility index (PI) to predict preeclampsia, with sensitivity 0.05 (95% CI 0.02–0.08) and specificity 0.44 (95% CI 0.28–0.61). Nine studies used the resistance index (RI), with sensitivity 0.13 (95% CI 0.05–0.27) and specificity 0.31 (95% CI 0.07–0.63). Three studies used the systolic/diastolic (S/D) ratio, with sensitivity 0.50 (95% CI 0.30–0.67) and specificity 0.86 (95% CI 0.68–0.95). Nine studies used notching, with sensitivity 0.20 (95% CI 0.09–0.35) and specificity 0.60 (95% CI 0.23–0.90). Conclusions Uterine artery Doppler parameters predicted preeclampsia differently. PI and RI had low sensitivity and specificity. S/D ratio had high sensitivity and specificity, useful for predicting preeclampsia. Notching had low sensitivity and high specificity. Uterine artery Doppler alone has limited use in predicting preeclampsia.