The role of second trimester uterine artery Doppler in pregnancies with systemic lupus erythematosus

OBJECTIVE: To assess the predictive value of second trimester mean uterine artery Doppler pulsatility-index (mUtA PI) for pregnancy complications in women with systemic lupus erythematosus (SLE). METHODS: Cohort study of consecutive pregnancies complicated with SLE during a 12 years period. SLE diagnosis was made before pregnancy. mUtA PI was measured between 23 + 0 and 26 + 6 weeks' gestation. Pregnancy and neonatal outcomes were collected. Small for gestational age (SGA) was defined as birth weight <10th percentile. Adverse pregnancy outcome (APO) was defined as one of the following: pre-eclampsia, SGA, placental abruption, stillbirth or neonatal death. Differential diagnosis between pre-eclampsia and renal flare was made according to SLE-disease activity index (SLEDAI) index. RESULTS: 70 pregnancies in 64 women. Pre-eclampsia was observed in 4 cases (6%), SGA in 5 (7%) and APO in 7 (10%). mUtA PI showed a sensitivity and a specificity of 1.0 (95% CI 0.5-1.0) and 1.0 (95% CI 0.95-1.0) for pre-eclampsia, 0.40 (95% CI 0.12-0.77) and 0.97 (95% CI 0.89-0.99) for SGA, 0.57 (95% CI 0.25-0.84) and 1.0 (95% CI 0.94-1.0) for APO, respectively. CONCLUSION: Our findings suggest that uterine artery Doppler is confirmed to be a high sensitivity and high specificity test for predicting pre-eclampsia even in SLE patients.