الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Preeclampsia and intrauterine growth restriction (IUGR) are major contributors to perinatal mortality and morbidity worldwide. Both are characterized by impaired trophoblastic invasion of the maternal spiral arteries and their conversion from narrow muscular vessels to wide non–muscular channels (Odibo AO et al., 2002).
Pre-eclampsia (PE) is a multi-system disorder particular to pregnancy. It is characterised by widespread endothelial dysfunction, resulting in hypertension due to vasocons¬triction, proteinuria attributable to glomerular damage and oedema secondary to increased vascular permeability, occurring in 2-4% of pregnancies, cons¬titutes a major risk factor for maternal and fetal morbidity and mortality in developed countries (Vanessa A. Rodie, 2006).
Intrauterine growth restriction (IUGR) or small for gestational age (SGA) occurs when the fetus is less than 10 percent of predicted fetal weight for gestational age. It can result in significant fetal morbidity and mortality if not properly diagnosed and managed. The condition is most commonly caused by inadequate maternal-fetal circulation. According to the common definition of IUGR, the expected incidence of IUGR should be 10 percent. The actual incidence, however, is only about 6 percent(David A Viiker, 2001).
Blood flow through the uteroplacental circulation can be studied non-invasively using Doppler ultrasound. The impedance to flow in the uterine arteries decreases with gestation in normal pregnancies, reflecting the trophoblastic invasion of the spiral arteries and their conversion into low-resistance vessels (Papageorghiou, 2005).
Conclusion
In conclusion, our results indicate that a one stage color Doppler of uterine artery screening at 23 weeks of gestation has proved useful in identifying women at high and low risk for developing complications of uteroplacental insufficiency (pre-eclampsia and/or fetal growth restriction) and may aid in stratifying antenatal care. The high-risk group was defined as women with increased PI >1.4 and/or bilateral D-notches.
Recommendations
Uterine artery Doppler at 23 weeks of gestation may predict preeclampsia and intrauterine growth restriction but, larger studies are needed to assess the predictive potential of second trimester uterine artery Doppler.
Further studies are needed to increase predictive value of uterine artery Doppler for adverse pregnancy outcome as the detection rates may be increased and false positive rates reduced by combination with maternal characteristics or serum markers. Furthermore, such screening might help in identifying effective prophylactic therapies, such as low-dose aspirin or vitamins C and E, as part of ongoing randomized trials.