Prediction of Preeclampsia by Mean Arterial Pressure at 11-13 and 20-24 Weeks' Gestation

Abstract

Objectives: To assess the performance of screening for preeclampsia (PE) by mean arterial pressure (MAP) at 11-13 and at 20-24 weeks' gestation. Methods: MAP was measured at 11-13 and 20-24 weeks in 17,383 singleton pregnancies, including 70 with early PE, requiring delivery <34 weeks' gestation, 143 with preterm PE, delivering <37 weeks and 537 with total PE. MAP was expressed as multiple of the median (MoM) after adjustment for maternal characteristics and corrected for adverse pregnancy outcomes. The performance of screening for PE by maternal characteristics and MAP MoM at 11-13 weeks (MAP-1), MAP MoM at 20-24 weeks (MAP-2) and their combination was evaluated. Results: In screening by maternal characteristics and MAP-1, at a false-positive rate (FPR) of 10%, the detection rates (DR) of early PE, preterm PE and total PE were 74.3, 62.9 and 49.3%, respectively; the DR at FPR of 5% were 52.9, 42.7 and 35.8%. In screening by MAP-1 and MAP-2 the DR at FPR of 10%, were 84.3, 65.7 and 52.5%; the DR at FPR of 5% were 60.0, 49.7 and 37.6%, respectively. Conclusions: Performance of screening for PE by MAP is best when measurements are taken at both 11-13 and 20-24 weeks' gestation than at only one of these gestational ranges.

Maternal Serum Biochemical Indicators of Trophoblastic Cell and Endothelial Function at First Trimester of Pregnancy

“…Mean arterial blood pressure (MAP) has been documented as a biophysical marker and is known to be a better predictor for screening preeclampsia [29] [30].…”

Prediction of small-for-gestational-age neonates: screening by uterine artery Doppler and mean arterial pressure at 19-24 weeks

“…Extensive studies at 19–24 weeks' gestation have reported that screening by measurement of uterine artery (UtA) pulsatility index (PI) can identify a high proportion of pregnancies that develop pre‐eclampsia (PE), especially those with severe early‐onset disease that is commonly associated with fetal growth restriction. These studies have also reported that increased UtA‐PI is observed in pregnancies with SGA fetuses/neonates in the absence of PE.…”

Prediction of small-for-gestational-age neonates: screening by uterine artery Doppler and mean arterial pressure at 30-34 weeks

“…Extensive screening studies at 11–13, 20–24 and 30–34 weeks' gestation have reported that, in pregnancies that develop PE, the uterine artery pulsatility index (UtA‐PI) is increased before the onset of clinical signs of the disease. There is also evidence that in such pregnancies the mean arterial pressure (MAP) at 11–13, 20–24 and 30–34 weeks is also increased before the onset of clinical signs of PE. Screening studies in the first and second trimesters have reported that in pregnancies that deliver SGA neonates in the absence of PE, the UtA‐PI is increased.…”