{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T06:07:13Z","timestamp":1783836433873,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Placenta\u2010mediated complications such as pre\u2010eclampsia (PE), fetal growth restriction (FGR), and preterm birth (PTB) remain leading causes of maternal and perinatal morbidity. First\u2010trimester screening tools, including the Fetal Medicine Foundation (FMF) algorithm and National Institute for Health and Care Excellence (NICE) criteria, help identify women at risk, but their predictive accuracy remains limited. This study evaluated whether second\u2010trimester uterine artery (UtA) Doppler measurements provided additional risk stratification within risk groups defined by either FMF or NICE\u2010based first\u2010trimester screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>This was a retrospective cohort study which included 5518 singleton pregnancies managed at University College London Hospital between 2019 and 2022. Women were stratified into four risk groups based on first (1) and second (2) trimester assessments: L1L2 (low risk in both trimesters), L1H2 (low risk in first, high risk in second), H1L2 (high risk in first, low in second), and H1H2 (high risk in both trimesters). First\u2010trimester risk was assessed using FMF or NICE models; second\u2010trimester high risk was defined as a mean UtA pulsatility index (PI) \u226595th centile. Primary outcomes included the incidence of PE, small for gestational age (SGA; birthweight &lt;10th centile), FGR (&lt;3rd centile), PTB before 34 and 37\u2009weeks, stillbirth, and a composite adverse outcome (PE, FGR, PTB, or stillbirth). Secondary outcomes were emergency cesarean section (EMCS), neonatal intensive care unit (NICU) admission, and NICU length of stay. This study was not designed to compare the intrinsic screening performance of NICE and FMF as first\u2010trimester tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Women classified as low risk in the first trimester but high risk in the second trimester had higher rates of adverse outcomes compared to those who remained low risk in both trimesters in both FMF\u2010 and NICE\u2010based stratification. Notably, women classified as high risk in both trimesters had the highest rates of placenta\u2010mediated complications, including PE, FGR, PTB, and stillbirth. This pattern was consistent across both first\u2010trimester risk frameworks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mid\u2010gestational UtA Doppler assessment improves prediction of placenta\u2010mediated complications when included with FMF or NICE screening. This two\u2010step approach enhances identification of high\u2010risk pregnancies and supports more personalized antenatal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70222","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:16:56Z","timestamp":1778822216000},"page":"1523-1530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improved risk stratification for placenta\u2010mediated complications through the use of mid\u2010gestational uterine artery Doppler: A retrospective cohort study"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8425-6534","authenticated-orcid":false,"given":"Christina","family":"Ammari","sequence":"first","affiliation":[{"name":"Institute for Women's Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Institute for Women's Health University College London  London UK"},{"name":"University College London Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Stott","sequence":"additional","affiliation":[{"name":"University College London Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Casagrandi","sequence":"additional","affiliation":[{"name":"University College London Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Nzelu","sequence":"additional","affiliation":[{"name":"University College London Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara L.","family":"Hillman","sequence":"additional","affiliation":[{"name":"Institute for Women's Health University College London  London UK"},{"name":"University College London Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23118"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19077"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58030332"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000696"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17613"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"issue":"10","key":"e_1_2_13_8_1","article-title":"Antiplatelet agents for preventing pre\u2010eclampsia and its complications","volume":"2019","author":"Duley L","year":"2019","journal-title":"Cochrane Database Syst 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