Abstract
This study aimed to examine the association between indicators of arterial resistance occurring late in the first trimester and the subsequent development of pregnancy-related hypertension. This study took place between May 2014 and August 2015 and included 329 consecutive women with singleton pregnancies attending the antenatal clinics of a medical college in Karnataka, India, during this period. Pulse pressure (PP) and uterine artery Doppler parameters were recorded between 11-14 gestational weeks. Consequently, women were followed-up until after delivery for subsequent hypertension. Hypertension occurred more frequently if PP was high (17.6% versus 14.4% of pregnancies without high PP; P = 0.713), if a diastolic notch (DN) was present (15.1% versus 12.8% of pregnancies with an absent DN; P = 0.612) and if the resistive index (RI) was raised (22.2% versus 14.3% of pregnancies without raised RI; P = 0.366). A raised pulsatility index (PI) was significantly associated with hypertension (P = 0.013). The risk of hypertension was approximately seven-fold higher if two or more arterial resistance indicators were used, except with a present DN plus a raised RI or a present DN plus high PP. All arterial resistance indicators showed negative predictability (>85.6%) and good specificity (≥95.0%), except for the presence of a DN. A population-specific cut-off PI value of 1.72 had high negative predictability (92.8%) and good sensitivity (70.8%) and specificity (65.1%). Raised PI in the late first trimester was a significant predictor of hypertension later in pregnancy. A combination of arterial resistance indicators may enhance prediction of subsequent hypertension.
Highlights
This study aimed to examine the association between indicators of arterial resistance occurring late in the first trimester and the subsequent development of pregnancy-related hypertension
- The findings of the current study indicate that selected indicators of arterial resistance in the late first trimester—including pulse pressure (PP) calculated from routinely recorded blood pressure measurements during regular healthcare visits and uterine artery pulsatility index (PI) determined via Doppler ultrasonography during nuchal translucency screening—can be used to predict the development of hypertension later in pregnancy
The present study aimed to examine the potential association between arterial resistance indicators in the late first trimester, including Pulse pressure (PP) and uterine artery Doppler flow velocimetry indices, and the occurrence of hypertension later in pregnancy
Summary
Abstract: Objectives: This study aimed to examine the association between indicators of arterial resistance occurring late in the first trimester and the subsequent development of pregnancy-related hypertension. Advances in Knowledge - Among the studied cohort, a raised uterine artery pulsatility index (PI) in the late first trimester was significantly associated with the development of hypertension later in pregnancy. - the risk of subsequently developing hypertension was approximately seven-fold higher if two or more arterial resistance indicators in the late first trimester were used in combination, except with certain combinations of indicators. - The findings of the current study indicate that selected indicators of arterial resistance in the late first trimester—including pulse pressure (PP) calculated from routinely recorded blood pressure measurements during regular healthcare visits and uterine artery PI determined via Doppler ultrasonography during nuchal translucency screening—can be used to predict the development of hypertension later in pregnancy
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