{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:57:25Z","timestamp":1788872245436,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the performance of mean uterine artery pulsatility index (UtA\u2010PI) at 18\u201322 and 24\u201328\u2009weeks of gestation in the prediction of pre\u2010eclampsia (PE) and small\u2010for\u2010gestational age (SGA), and its role in reassessing the risk of PE and SGA in pregnancies screened for PE in the first trimester.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective observational cohort study of 4464 women with singleton pregnancy screened routinely for PE in the first trimester, using the Gaussian algorithm, from March 2019 to May 2021, and who underwent UtA\u2010PI assessment at 18\u201322 gestational weeks. Women were categorized as low risk or high risk based on the risk index obtained after first\u2010trimester screening for PE. In high\u2010risk patients, UtA\u2010PI was also assessed at 24\u201328\u2009weeks of gestation. Sensitivity, specificity, positive predictive value, negative predictive value (NPV), positive likelihood ratio, negative likelihood ratio and area under the receiver\u2010operating\u2010characteristics curve were calculated to assess the performance of UtA\u2010PI at 18\u201322 and 24\u201328\u2009weeks in predicting PE and SGA in the high\u2010risk group. In all participants, different UtA\u2010PI percentiles at 18\u201322 or 24\u201328\u2009weeks, or their combination, were analyzed to explore their role in reassessing the risk of PE and SGA following first\u2010trimester PE screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The performance of UtA\u2010PI at 18\u201322 and 24\u201328\u2009weeks in the high\u2010risk group was good for predicting preterm PE and preterm SGA, and excellent for predicting early\u2010onset PE and early\u2010onset SGA, with an NPV of &gt;\u200997% for all outcomes. In the low\u2010risk group, UtA\u2010PI \u2265\u200995<jats:sup>th<\/jats:sup> percentile at 18\u201322\u2009weeks' gestation identified a subgroup of pregnancies with a significantly higher risk of preterm SGA compared to the low\u2010risk group. In the high\u2010risk group, UtA\u2010PI &lt;\u200960<jats:sup>th<\/jats:sup> percentile at 18\u201322\u2009weeks' gestation, UtA\u2010PI &lt;\u200985<jats:sup>th<\/jats:sup> percentile at 24\u201328\u2009weeks' gestation, and UtA\u2010PI &lt;\u200985<jats:sup>th<\/jats:sup> percentile at 24\u201328\u2009weeks' gestation in women with UtA\u2010PI \u2265\u200960<jats:sup>th<\/jats:sup> percentile at 18\u201322\u2009weeks, identified subgroups of pregnancies with a risk of PE and SGA comparable to that of the low\u2010risk group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The performance of UtA\u2010PI at 18\u201322 and 24\u201328 gestational weeks in high\u2010risk pregnancies identified during first\u2010trimester screening for PE is similar to that in the general population. The risk of PE and SGA in a high\u2010risk cohort can be reassessed by measuring UtA\u2010PI at 18\u201322\u2009weeks, 24\u201328\u2009weeks or both, allowing adjustment of follow\u2010up, particularly de\u2010escalation of care. \u00a9 2024 The Author(s). <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.29145","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T00:40:23Z","timestamp":1733445623000},"page":"63-70","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Role of routine uterine artery Doppler at 18\u201322 and 24\u201328 weeks' gestation following routine first\u2010trimester screening for pre\u2010eclampsia"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8042-8247","authenticated-orcid":false,"given":"E.","family":"Bonacina","sequence":"first","affiliation":[{"name":"Maternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Del Barco","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Farr\u00e0s","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Dalmau","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Unit, 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