{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:34:48Z","timestamp":1788435288700,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,4,21]],"date-time":"2011-04-21T00:00:00Z","timestamp":1303344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the use of second\u2010trimester uterine artery (UtA) Doppler to predict adverse pregnancy outcome in women with extreme levels of fetoplacental proteins used for Down syndrome screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>At a single institution, women screened for Down syndrome were offered second\u2010trimester UtA Doppler examination if they had one of the following on analysis of maternal serum: pregnancy\u2010associated plasma protein\u2010A \u2264 0.28 multiples of the median (MoM) (1% of screened population), inhibin \u2265 3.0 MoM (2%), human chorionic gonadotropin \u2265 4.0 MoM (2%), alpha\u2010fetoprotein (AFP) \u2265 2.5 MoM (2%), estriol \u2264 0.5 MoM (1%). Abnormal UtA Doppler was defined as bilateral or unilateral notching or mean pulsatility index \u2265 1.45.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 240 women studied, 92 (38.3%) had an adverse pregnancy outcome: small for gestational age (either &lt; 10<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> customized centile (<jats:italic>SGA<\/jats:italic><jats:sub>10<\/jats:sub>) or &lt; 5<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> customized centile (SGA<jats:sub>5<\/jats:sub>)), low birth weight (LBW, &lt; 2.5 kg), preterm delivery (&lt; 37 + 0 weeks of gestation), fetal loss (late miscarriage or stillbirth), placental abruption and gestational hypertension. Of 167 women screened with all five hormones, those with two or more extreme levels (<jats:italic>n<\/jats:italic> = 18, 10.8%) were significantly at risk of adverse pregnancy outcome compared with those with only one marker (61.1% vs. 35.6%, <jats:italic>P<\/jats:italic> = 0.04). UtA Doppler was abnormal in 20% (32 of 159 women screened) and increased the risk of adverse pregnancy outcome (RR 2.5, 65.6% vs. 26.0%, <jats:italic>P<\/jats:italic> &lt; 0.001). SGA<jats:sub>10<\/jats:sub>, SGA<jats:sub>5<\/jats:sub> and LBW were significantly more common in women with abnormal UtA Doppler (RR 2.98, 56.2% vs. 18.9%, <jats:italic>P<\/jats:italic> &lt; 0.001, RR 4.6, 43.7% vs. 9.4%, <jats:italic>P<\/jats:italic> &lt; 0.001 and RR 4.4, 31.2% vs. 7.1%, <jats:italic>P<\/jats:italic> &lt; 0.001, respectively). Women with normal Doppler examination still had a 26% risk of adverse pregnancy outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women with extreme levels of feto\u2010placental proteins used for Down syndrome screening, an abnormal second\u2010trimester UtA Doppler examination confers a high risk of adverse pregnancy outcome and SGA in particular, but a normal examination does not rule out an adverse pregnancy outcome. Copyright \u00a9 2011 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.8901","type":"journal-article","created":{"date-parts":[[2010,12,10]],"date-time":"2010-12-10T14:45:19Z","timestamp":1291992319000},"page":"520-527","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Uterine artery Doppler and adverse pregnancy outcome in women with extreme levels of fetoplacental proteins used for Down syndrome screening"],"prefix":"10.1002","volume":"37","author":[{"given":"E.","family":"Filippi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Staughton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Peregrine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Huttly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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