Author:
Ridding Gus,Schluter Philip J.,Hyett Jon A.,McLennan Andrew C.
Abstract
Introduction: Uterine artery pulsatility index (PI) is a key variable in the first trimester screening for pre-eclampsia. The aims of the study were to examine the effect of sampling the uterine arteries at a site distal to the level of the internal os, and to determine a lower limit of peak systolic velocity (PSV) to establish an auditable standard. Material and Methods: PI and PSV measurements were performed at 11-13+6 weeks' gestation at two sites: at the level of the internal os and 3 cm distal to the internal os. Comparative analyses utilised the Student's paired t-test. A 90% reference interval of transformed PSV measurements at the internal os was generated by polynomial regression. Results: There was a significant reduction in both the PI (14.9%) and the PSV (17.4%) when measured at the distal site compared to the level of the internal os (both p < 0.001). The best estimated 5th centile for uterine artery PSV at 11-13+6 weeks was 60.9 cm/s. Conclusion: PI measurements performed distal to the internal os are significantly lower and will result in inaccurate pre-eclampsia risk assessment. PSV measurements below 60 cm/s are likely to indicate an incorrect sampling site. Development of auditable measurement standards is important to ensure accuracy of prospective pre-eclampsia screening.
Subject
Obstetrics and Gynaecology,Radiology Nuclear Medicine and imaging,Embryology,General Medicine,Pediatrics, Perinatology, and Child Health
Cited by
18 articles.
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