Uterine artery Doppler screening for pre‐eclampsia: comparison of the lower, mean and higher first‐trimester pulsatility indices

Objectives A previous study suggested that the lower uterine artery pulsatility index (PI) is a better predictor of pre‐eclampsia than is either the mean or higher indices. The aim of this study was to assess the relative value of these three indices for the prediction of pre‐eclampsia in the first trimester of pregnancy. Methods This was a prospective study of 6221 singleton pregnancies. Uterine artery PI was obtained at the time of the 11–14‐week nuchal translucency scan and receiver–operating characteristics curves for the lower, mean and higher PI value of the two uterine arteries in the prediction of pre‐eclampsia were calculated. Results There were 178 cases of pre‐eclampsia. The associations between uterine artery PI and pre‐eclampsia were stronger for early (requiring delivery < 34 weeks' gestation) and preterm (requiring delivery < 37 weeks) pre‐eclampsia compared to pre‐eclampsia at any gestation. There was no significant difference in the strength of the association between lower, mean and higher PI for pre‐eclampsia at any gestation. Conclusions First‐trimester uterine artery PI is strongly associated with the development of early and preterm pre‐eclampsia. Lower, mean and higher uterine artery PIs are comparable in screening for pre‐eclampsia. Any differences that exist between the lower, mean and higher uterine artery indices are unlikely to have a significant impact on screening sensitivities. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.