|Source||Location and Type of Study||Intervention||Stillbirths/Perinatal Outcomes|
|Reviews and meta-analyses|
|Papageorghiou et al. 2002 ||
Review. 15 studies of routine Doppler assessments in pregnancy in unselected populations.
|Sought to relate the risk of antepartum stillbirth to uterine artery Doppler flow velocimetry at 22–24 weeks.||
Fetal growth restriction and perinatal death associated with impeded uterine artery flow.|
Positive Doppler diagnosis appropriately identified ~40% of women who subsequently developed pre-eclampsia (6-fold increased risk with positive Doppler) and ~20% of fetal growth restriction cases (3.5-fold increased risk)
|Subtil et al; Essai Régional Aspirine Mère-Enfant (ERASME) Collaborative Group 2003. ||
France and Belgium.|
Multicentre RCT. Nulliparous women (N = 1853; N = 1253 intervention, N = 617 controls) 14–20 wks gestation.
|Compared the impact of uterine Doppler (intervention) versus placebo (controls) on PMR. Women with abnormal Doppler waveforms received 100 mg of aspirin daily from Doppler exam until 36 wks.||
PMR: RR = 4.02 (95% CI: 0.5–32.0) [NS]|
[8/1249 (0.6%) vs. 1/327 (0.2%) in intervention vs. control groups, respectively].
|Smith et al. 2007 ||
Observational study. Unselected women (N = 30,519) who had uterine artery Doppler performed 22–24 wks of gestation.
|Studied the relationship between abnormal (mean pulsatility index in the top decile and a bilateral notch) vs. normal Doppler flow on the risk of antepartum stillbirth.||
Antepartum SBR: adj. HR = 5.5 (95% CI: 2.8–10.6) in Doppler with mean pulsatility index in the top decile vs. controls.|
Antepartum SBR: adj. HR = 3.9 (95% CI: 2.0–7.8) in Doppler with a bilateral notch versus controls.
Unexplained SBR: adj. HR 2.5 (95% CI: 1.1–5.6) in Doppler with mean pulsatility index in the top decile vs. controls. No association between Doppler with a bilateral notch and SB.