[Value of the systematic uterine Doppler in the primiparous woman. A series of 315 cases]

Abstract

Objective: This retrospective study was designed to assess the screening of pre-eclampsia (PE) and intra-uterine growth retardation (IUGR) by uteroplacental doppler scan in a population of primiparous, selected in a hospital having 700 deliveries each year.

Study design: We studied, a consecutive series of 315 primiparous women at 19 weeks (gestational age) screened by pulsed Doppler of uterine artery. Group A (normal uterine artery Doppler) was compared with group B (pathological uterine artery Doppler) for pregnancy-induced hypertension, preeclampsia and intra-uterine growth retardation (chi 2 test and Fisher test).

Results: Group B included 50 patients (15%). They had more hypertensive pathologies (24%) (p < 0.001) and IUGR (20%) (p < 0.005) were more frequent than the group A (265 patients: 85%) which had only 7.2% and 8.2% respectively. In this study, the sensitivity of uterine artery Doppler was 34.3%, the specificity was 88.5%, the positive predictive value was 42%, the negative predictive value was 84.9% for all hypertensive disorders.

Conclusion: The contribution of this examination is doubtful in a low risk population where the prevalence of complications is low and the VPP is about 10 to 14% for preeclampsia. On the other hand, test predictivity reaches 50% for all dysgravidic disorders.