The value of uterine artery Doppler flow velocity in the prediction of uncomplicated pregnancies

A review of the literature was performed in order to investigate whether uterine artery Doppler flow velocity at 22 weeks' pregnancy would be an appropriate test to distinguish low risk from high risk pregnancies. A search of the literature identified 65 studies on uterine artery Doppler flow velocity in relation to pregnancy complications. There remained 14 low risk population studies, involving 31,621 pregnant women. The negative predictive value in the low risk population for pre-eclampsia is 99% and for IUGR 95%. The negative predictive values for early pre-eclampsia and early IUGR with the highest risk of perinatal mortality and severe maternal morbidity are 100%. Sensitivity for severe adverse complications before 32 weeks is 89% and specificity is 90%. Likelihood ratio of a positive test is 8.9% and of a negative test is 0.12. The Dutch obstetric system is based on risk selection. Routine screening by uterine artery Doppler around 22 weeks' pregnancy might be appropriate because of the high negative predictive value for severe pregnancy complications.