Özet:

OBJECTIVE: The aim of study is to evaluate the efficacy of uterin arter Doppler ultrasonography to predict preeclampsia, intrauterine growth restriction and premature birth in low riskTurkish population. MATERIALS and METHODS: 1029 women who were admitted to antenatal clinic and fetal biometry, second trimester anomaly scanning and bilateral uterine artery spectral Doppler performed were included in this study. Multiple pregnancies and fetal anomalies were excluded. Outcome of pregnancy-related data obtained by the help of a standard telephone interview form. Bilateral uterine artery z-scores of the PI values calculated and differences in the average PI-z scores between control group and separately <5 persantile birth, preeclampsia, premature birth group evaluated. With the help of ROC curves for each poor prognosis, the optimal threshold values were determined and according to these values diagnostic predictions of Doppler application were revealed. The frequencies of uterine artery notch were determined and diagnostic values for prediction of poor prognosis were identified. RESULTS: In women; 43 (4%) preeklampsia, 62 (6.1%) <5 persantile birth (IUGR), 214 (20,8%) <37 weeks birth, 6 (0.6%) intrauterine death, 36 (3.5%) neonatal deaths were seen. Uterine artery pulsatility index (UAPI) Z score mean values of preeclampsia, IUGR, premature birth were 0.53, 0.55, 0.14, respectively.UAPI - z scores of the optimum threshold values for preeclampsia, IUGR, premature birth were 0.12, 0:59 and 1:58, respectively. In these threshold of z scores in the uterine artery, sensitivity, specificity, positive predictive value(PPD) and negative predictive value (NPD) for preeclampsia were 0.44, 0.76, 0.07, 0.97; for IUGR 0.22, 0.83, 0.07, 0.95 and for premature birth 0.09, 0.93, 0.24, 0.79, respectively. Bilateral uterine artery diastolic notches revealed a high percentage in preeclampsia, intrauterine growth retardation group(p<0,05). In the preterm group no difference was seen. For prediastolic notch sensitivity, specificity, PPD and NPD in pre-eclampsia, respectively, 0.25, 0.83, 0.05, 0.87; inIUGR0.31, 0.86, 0.23, 0.82. CONCLUSION: Uterine artery Doppler ultrasound might contribute to the prediction of poor obstetric prognosis in low riskTurkish population.

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