Uterine artery Doppler velocimetry and the outcome of pregnancies resulting from ICSI

BACKGROUND: An increased incidence of pregnancy complications following ass isted reproduction has been reported, The use of uterine artery Doppler ult rasound may aid the prediction of such complications. METHODS: Doppler was performed at 18-24 weeks gestation in 114 singleton and 32 twin pregnancies after intracytoplasmic sperm injection (ICSI) and compared with a control group matched for age, parity and plurality, Outcome variables included ges tational age at delivery, prematurity, preterm premature rupture of membran e (PPROM), birth weight, birth weight discordance of > 20% in twins, small for gestational age (SGA), mode of delivery, development of preeclampsia an d placental abruption. RESULTS: Compared with the controls, there were no s ignificant differences concerning uterine Doppler parameters, pregnancy com plications and the neonatal outcome, either in singleton or in twin pregnan cies, According to Doppler results and/or risk factors by medical history, 42% of singleton ICSI and 39% of spontaneous singleton pregnancies were con sidered as high risk. In singletons, abnormal Doppler findings were associa ted with pre-eclampsia in 22% and SGA in 26% of ICSI patients, compared wit h 33 and 21% in controls; in contrast, 0 and 10% in ICSI and 3 and 6% in co ntrols showed these complications but no risk factors respectively. No corr elation was found between PPROM, prematurity, the rate of Caesarean section and pathological Doppler results, CONCLUSIONS: Uterine Doppler examination holds the potential to identify patients with an increased risk for develo ping pregnancy complications, According to our results, this risk is not el evated after ICSI treatment, therefore the decision of offering an intensif ied antenatal care should be based on the results of Doppler examination or risks by medical history rather than the mode of conception.