International Society of Ultrasound in Obstetrics and Gynecology The guidelines on preeclampsia ultrasound were released by the International Society of Ultrasound in Obstetrics and Gynecology on October 15, 2018.[1] The pulsatility index (PI) should be used for examination of uterine artery resistance in the context of preeclampsia (PE) screening. Doppler examination of the uterine arteries at 11 + 0 to 13 + 6 weeks can be performed either transabdominally or transvaginally, according to local preferences and resources. Because maternal factors can affect uterine artery PI, inclusion of uterine artery PI in a multifactorial screening model should be preferred over its use as a standalone test with absolute cut‐offs, whenever feasible. Mean uterine artery PI should be the Doppler index of choice for first-trimester screening. Doppler examination of the uterine arteries at the second‐trimester scan can be performed either transabdominally or transvaginally. Mean uterine artery PI should be used for prediction of PE. In the case of a unilateral placenta, a unilaterally increased PI does not appear to increase the risk for PE if the mean PI is within normal limits. Although uterine artery velocimetry can be assessed transvaginally, the most common method of uterine artery Doppler examination in the third trimester is a transabdominal approach. The most efficient screening model for identification of women at risk of PE seems to be a combination of maternal factors, maternal mean arterial blood pressure, uterine artery Doppler, and placental growth factor (PlGF) level at 11-13 weeks. There is convincing evidence that low‐dose aspirin can significantly decrease the risk of early PE when begun at first‐trimester screening. Source
