Uterine Artery Dopplers

• Indications:
  • CHTN
  • Preeclampsia, Hx Preeclampsia
  • Chronic renal disease
  • Pre-gestational DM
  • PCOS
  • Low PAPP-A
  • Elevated HCG
  • Increased Inhibin
  • Low Estriol
  • Elevated AFP
  • Multiple gestations
  • Anti-phospholipid Syncrome (APLs)
    • +LLI
    • +Anti-cardiolipin Ab’s.
  • Thrombophilia
    • Factor V Leiden
    • Factor II Leiden
    • MTHFR
    • Low Antithrombin
    • Low Protein S or C
  • SLE or other collagen vascular disease:
    • Rheumatoid Arthritis
    • Sjogren’s disease
    • Scleroderma
    • Mixed connective tissue disease
  • Hx abruption
  • IUGR, Hx IUGR
  • Hx 2nd or 3rd trimester IUFD
• Performed between 20-24 weeks and per individual MD preference
• Always performed bilaterally.
• Obtain waveform while observing for notching. A minimum of 3 cycles should be obtained.
• Procedure
  2. Using color flow doppler, locate the uterine artery by positioning transducer in the adnexa and angling toward cervix. The uterine artery appears to course toward the fundus and can be seen to cross with the internal iliac artery at the level of the cervix.
  3. Doppler gate should be placed medially to this crossing by 1-2cm to obtain the most accurate sample.
     • NOTE: Normal waveform is monophasic with continuous forward flow, relatively high diastolic flow and low resistance.
  4. Use continuous trace caliper to manually trace a minimum of 3 waveforms
  5. Report any notching along with the PI percentile (found on graphs at each office) to MD.