{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T14:30:32Z","timestamp":1779201032030,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate whether routine mid\u2010gestational uterine artery Doppler (UtAD) modifies the risk for preterm pre\u2010eclampsia after first\u2010trimester combined pre\u2010eclampsia screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>London Tertiary Hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A cohort of 7793 women with singleton pregnancies, first\u2010trimester pre\u2010eclampsia screening using the Fetal Medicine Foundation (FMF) algorithm and UtAD pulsatility index (PI) assessment at the mid\u2010gestation ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pregnancies were divided into four groups: high risk in both trimesters (H<jats:sup>1<\/jats:sup>H<jats:sup>2<\/jats:sup>), high risk in the first but not in the second trimester (H<jats:sup>1<\/jats:sup>L<jats:sup>2<\/jats:sup>), low risk in the first but high risk in the second trimester (L<jats:sup>1<\/jats:sup>H<jats:sup>2<\/jats:sup>) and low risk in both trimesters (L<jats:sup>1<\/jats:sup>L<jats:sup>2<\/jats:sup>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Small for gestational age (SGA), hypertensive disorders of pregnancy (HDP) and stillbirth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this cohort, 600 (7.7%) and 620 (7.9%) women were designated as being at high risk in the first and second trimesters, respectively. Preterm pre\u2010eclampsia was more prevalent in the H<jats:sup>1<\/jats:sup>L<jats:sup>2<\/jats:sup> group (4.5%) than in women considered at low risk in the first trimester (0.4%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The prevalence of preterm pre\u2010eclampsia in the L<jats:sup>1<\/jats:sup>H<jats:sup>2<\/jats:sup> group (3.3%) was significantly lower than that in women considered at high risk in the first trimester (7.0%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0076), and was higher than that observed in the L<jats:sup>1<\/jats:sup>L<jats:sup>2<\/jats:sup> group (0.2%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The prevalence of SGA and term HDP followed similar trends.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pre\u2010eclampsia risk after first\u2010trimester FMF pre\u2010eclampsia screening may be stratified through mid\u2010gestational routine UtAD assessment. Pregnancy care should not be de\u2010escalated for low mid\u2010gestational UtAD resistance in women classified as being at high risk in the first trimester. The escalation of care may be justified in women at low risk but with high mid\u2010gestational UtAD resistance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17441","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T08:07:39Z","timestamp":1677571659000},"page":"1128-1134","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Is mid\u2010gestational uterine artery Doppler still useful in a setting with routine first\u2010trimester pre\u2010eclampsia screening? 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