Colour Doppler ultrasound of spiral artery blood flow in the prediction of pre-eclampsia and intrauterine growth restriction

Pre-eclampsia and intrauterine growth restriction are responsible for significant maternal and fetal morbidity and mortality worldwide. Identifying pregnancies at highest risk for their development would allow increased surveillance in individual pregnancies and also allow therapeutic trials to decrease their incidences in the future. To date, multiple attempts to develop a screening test for these disorders have met with limited success. Proposed screening methods have included maternal serum biochemical parameters as well as ultrasonographic markers. Uterine artery Doppler, direct evaluation of the spiral arteries using colour and spectral Doppler, three-dimensional placental volume analysis and, most recently, three-dimensional power Doppler angiography have all been suggested. Although an adequate screening method remains elusive, advances in ultrasound technology have improved our ability to observe the pathophysiologic changes that occur with these conditions early in pregnancy, bringing us closer to a reproducible screening model.