Uterine artery impedance at very early clinical pregnancy

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ObjectiveThe aim of the study was to construct gestational age-based reference ranges for the uterine artery (UtA) mean pulsatility (PI) and resistance (RI) indices from 6 to 10 weeks of pregnancy.MethodA prospective, cross-sectional, observational study was carried out in 312 singleton pregnancies with gestational age ranging from 6 to 10 weeks. UtAs were examined transvaginally by color and pulsed Doppler imaging, and the mean of the right and left values of PI and RI, as well as the presence or absence of a bilateral protodiastolic notch, was recorded. UtA-PI and UtA-RI reference percentiles were derived through time-conditional quantile regression.ResultsThe authors derived the 10th, 50th, and 90th reference percentile curves and correspondent 95% confidence intervals, for the evolution of the UtA mean PI and RI from week 6 to week 10 of gestation. The prevalence of bilateral notching absence was 8.1% (6/74) at 6 weeks and 28.8% (15/52) at 10 weeks.ConclusionThe authors present evidence of progressive reduction of uterine vascular impedance in a very early stage of pregnancy and provide new, averaged UtA-PI and UtA-RI charts between 6 and 10 weeks of gestation. © 2014 John Wiley & Sons, Ltd.What's already known about this topic?There is a consistent, progressive reduction on uterine artery impedance along the pregnancy from 11 weeks onwards, with predictive value for preeclampsia in selected groups of patients.What does this study add?The median, 10th, and 90th percentile regression curves of the pulsatility and resistance indices of the uterine artery decrease from the sixth to the tenth week of gestation.

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