Accessible Requires Authentication Published by De Gruyter June 1, 2005

Preeclampsia – abnormal uterine artery Doppler is related to recurrence of symptoms during the next pregnancy

Haraldur M. Gudnasson, Mariusz Dubiel and Saemundur Gudmundsson
From the journal

Abstract

Background: Impaired trophoblast invasion is suggested as the main cause of reduced placental perfusion, which results in fetal growth restriction and preeclampsia. Immunological response against the invading tissue has been given as the explanation. Preeclampsia frequently recurs during the next pregnancy. Doppler ultrasound can predict increased vascular impedance in the uteroplacental circulation. Whether signs of increased vascular resistance in pregnancies complicated by preeclampsia are predictive of recurrence during the next pregnancy is unknown.

Methods and material: Uterine artery Doppler was performed in 570 pregnant women with preeclampsia. Of these, 139 became pregnant again. The uterine artery Doppler results during the first pregnancy were related to symptoms of preeclampsia in the succeeding pregnancy.

Results: Preeclampsia developed again in 43 of the 139 women. Pregnancies with signs of increased uterine artery vascular impedance during the first pregnancy were 3.4 times more likely to develop preeclampsia again (CI 1.58–7.6). Similar results for a small for gestational age newborn were 9.7 (CI 1.1–90).

Conclusion: Increased uterine artery vascular impedance in pregnancies complicated by preeclampsia increases the likelihood of recurrence and growth restriction during the next pregnancy. The Doppler information gathered during the first pregnancy might thus select cases for special surveillance and possibly prophylactic anti-platelet treatment in the next pregnancy.

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Corresponding author: Saemundur Gudmundsson, MD, PhD, University of Lund, Department of Obstetrics and Gynecology, University Hospital MAS, SE-205 02 Malmö/Sweden. Tel: +46 40 332095, Fax: +46 40 962600, E-mail:

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Published Online: 2005-06-01
Published in Print: 2004-09-01

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