First trimester uterine artery pulsatility index levels in euploid and aneuploid pregnancies
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To examine whether the uterine artery PI is different in aneuploid and euploid pregnancies.
Retrospective case-matched study at the department of prenatal medicine at the University of Tuebingen, Germany. The study involved patients with complete data on first trimester screening for trisomies and preeclampsia except PlGF. For each case with trisomy 21 we randomly selected 50 cases with a euploid fetus where complete data on screening for aneuploidy and preeclampsia were also available. The uterine artery pulsatility index and the corresponding MoM values of euploid and the aneuploid population were compared with a Man–Whitney U test.
The dataset consisted of 4591 singleton pregnancies. The karyotype was normal in 4500 cases and was abnormal in the remaining 91 pregnancies. There were 50 pregnancies with trisomy 21, 31 with trisomy 18 and 13, and 10 with triploidy. In the group with euploid fetuses, median uterine artery PI was 1.55 (0.99 MoM). In the group with trisomy 21, the median PI (1.42) and MoM (0.89) levels were both significantly lower than in the euploid (p < 0.001). However, the measurements in the trisomy 18 and 13 [1.61 (0.93 MoM)] and in the triploidy [1.99 (1.13 MoM)] groups were not significantly different from those in the euploid group (p = 0.468 and p = 0.632, respectively).
In conclusion, uterine artery PI levels in the first trimester are slightly lower in pregnancies with trisomy 21. This knowledge may prove to be useful in cases where a low PAPP-A level is seen on the first trimester maternal serum biochemical evaluation to differentiate whether the more likely cause for this finding is placental dysfunction or aneuploidy, specifically trisomy 21.
KeywordsUterine artery doppler Preeclampsia Trisomy First trimester
NP manuscript writing, Data collection and analysis. PW data collection. JS manuscript writing and editing. MH data collection. AM data collection. SB manuscript writing and editing. KOK project development, Data analysis, manuscript writing and editing.
Compliance with ethical standards
Conflict of interest
All authors declare that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
This is a retrospective study involving ultrasound images from patients that were seen at the University of Tuebingen, Germany. All patients have agreed that clinical data can be used for retrospective studies. The study was approved by the local ethical committee. This is also stated in the Methods section (No. 350/2019BO2).
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