Uterine Artery Doppler Ultrasonography for First Trimester Prediction of Preeclampsia in Individuals at Risk from Low-Resource Settings.

Mihaela Oancea,Mihaela Grigore,Doru Diculescu,Carmen Bucuri,Dan Mihu,Diana Bodean,Stefan Strilciuc,Maria Rada,Razvan Ciortea

doi:10.3390/medicina56090428

Abstract

Background and objectives: The objective of this study was to evaluate the potential of first trimester uterine artery Doppler ultrasonography for the early prediction of preeclampsia (PE), in at-risk pregnant women. Materials and Methods: This was a prospective longitudinal study, including 120 Caucasian pregnant women with risk factors for PE. The potential of pulsatility indexes (PI) and notch was assessed as a tool for preeclampsia screening. Results: Doppler examination of the uterine artery performed early at 11–14 WA allows the detection of pregnancies that will develop PE with a sensitivity of 61.5% and a specificity of 63.8% based on PI analysis. Predictive power increases slightly by adding bilateral notch (sensitivity = 65.4%; specificity = 66%). Conclusions: Uterine artery Doppler examination is an effective non-invasive screening test for the development of PE in pregnancies at risk, particularly appropriate in health systems with limited means of evaluating other biomarkers.

Highlights

Preeclampsia (PE) is one of the most severe complications of pregnancy and remains a principal cause of maternal–fetal mortality and morbidity worldwide
A prospective longitudinal study of Caucasian pregnant women with risk factors for PE was waived by the institutional review board of the Iuliu Hatieganu University of Medicine and Pharmacy in Cluj-Napoca
Group I was comprised of 26 patients who developed PE (21.6%), out of which nine had severe and 17 had moderate forms

Summary

Introduction

Preeclampsia (PE) is one of the most severe complications of pregnancy and remains a principal cause of maternal–fetal mortality and morbidity worldwide. Trophoblast invasion failure, supposedly due to the interaction between exposure to risk, presence of polymorphic genes and several other factors (vasoactive and vascular remodeling proteins, thrombophilia, hypofibrinolysis, oxidative stress, lipid metabolism, endothelial injury and immunogenetic factors), deters physiological remodeling in the spiral arteriolar walls [9] Changes in these physiological processes determine high resistance circulation in the terminal vascular territory of spiral arteries. The objective of this study was to evaluate the potential of first trimester uterine artery Doppler ultrasonography for the early prediction of preeclampsia (PE), in at-risk pregnant women. Conclusions: Uterine artery Doppler examination is an effective non-invasive screening test for the development of PE in pregnancies at risk, appropriate in health systems with limited means of evaluating other biomarkers

Objectives

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Results

Conclusion