Usefulness of uterine artery Doppler velocimetry as a predictor for hypertensive disorders in pregnancy in women with prehypertension before 20 weeks gestation

Yang, Sean; Cho, Soo Hyun; Kang, Young Sun; Park, Seung Hwa; Sohn, In Sook; Kwon, Han Sung; Hwang, Han Sung

doi:10.1371/journal.pone.0210566

Cited by 9 publications

(12 citation statements)

References 29 publications

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“…The characteristics of the articles included in the metaanalysis are summarized in Table 1. All 12 articles [17][18][19][20][21][22][23][24][25][26][27][28] were observational studies; 4 were prospective cohort studies and 8 were retrospective cohort studies. Automatic blood pressure sphygmomanometers were used in 8 of 10 articles that discussed the use of blood pressure-measuring devices.…”

Section: Resultsmentioning

confidence: 99%

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Maternal and perinatal outcomes according to blood pressure levels for prehypertension: A review and meta-analysis

Suzuki

Takagi

Matsubara

et al. 2022

Hypertens Res Pregnancy

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This study aimed to examine whether blood pressure ≥ 130/ 80 mmHg is an appropriate reference value for hypertension in pregnant women by conducting a meta-analysis of studies reporting maternal/perinatal outcomes according to blood pressure levels at < 20 weeks of gestation. Methods: The meta-analysis of studies identified through PubMed / MEDLINE and Ichushi-Web searches was conducted to evaluate the incidence of preeclampsia, gestational hypertension, hypertensive disorders of pregnancy, preterm birth, and small-for-gestational-age birth. Results:The meta-analysis of 12 prospective and retrospective cohort studies revealed that the risks of preeclampsia, gestational hypertension, and hypertensive disorders in pregnancy were higher in women with blood pressure ≥ 120/ 80 mmHg, particularly ≥ 130/ 80 mmHg, relative to < 120/ 80 mmHg. The risk of preterm birth was higher in women with blood pressure ≥ 120/ 80 mmHg, and significantly higher in those with blood pressure ≥ 140/ 90 mmHg, relative to < 120/ 80 mmHg. The risk of small-for-gestational-age birth did not differ significantly by blood pressure status. Conclusions: Blood pressure ≥ 120/80 mmHg, particularly ≥ 130/80 mmHg, is associated with increased maternal and perinatal risks. We propose new blood pressure categories as normal ( < 120/ 80), high normal (120-129/ < 80), and elevated (130-139/ 80-89), although further studies will be needed to set ≥ 130/ 80 mmHg as a new reference for hypertension in pregnant women.

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Section: Resultsmentioning

confidence: 99%

“…Regarding these 7 articles, no antihypertensive medication was administered for blood pressure ≥ 140/90 mmHg except in one article. 17) The administration of aspirin was described in 3 of 12 articles (2 18,20) with, and 1 22) without aspirin administration).…”

Section: Resultsmentioning

confidence: 99%

Maternal and perinatal outcomes according to blood pressure levels for prehypertension: A review and meta-analysis

Suzuki

Takagi

Matsubara

et al. 2022

Hypertens Res Pregnancy

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“…On the other hand, examination of uterine artery flow (UtAF) by Doppler ultrasonography during second trimester can be used as a predictor for hypertensive disorders of pregnancy [14]. Uterine artery Doppler-pulsatility index (UtAD-PI) in combination with the presence of protodiastolic notch has been reported as a good tool for preeclampsia prediction [15].…”

Section: Introductionmentioning

confidence: 99%

“…Both serum sEng levels and UtAF flow Doppler ultrasonography in the second trimester of pregnancy have been proposed as tools for the prediction of preeclampsia and other adverse outcomes [5, 14, 15, 17]. However, it has been suggested that no single test reliably predicts preeclampsia, and further prospective investigation is required to demonstrate the clinical utility of these markers [1].…”

Section: Introductionmentioning

confidence: 99%

Soluble Endoglin and Uterine Artery Flow Doppler Ultrasonography as Markers of Progression to Preeclampsia in Women with Gestational Hypertension

Molina-Pérez

Leaños

Juárez

et al. 2021

Gynecol Obstet Invest

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Introduction: Gestational hypertension (GH) pregnancies are at a high risk of developing adverse outcomes, including progression to preeclampsia. Prediction of GH-related adverse outcomes is challenging because there are no available clinical tests that may predict their occurrence. Objective: The aim of the study was to determine the clinical usefulness of the soluble endoglin (sEng) and parameters of uterine artery flow (UtAF) measured by Doppler ultrasonography as markers of progression to preeclampsia in women with GH. Setting: Mexico City, Mexico. Material and Methods: We included 77 singleton pregnant women with GH in a nested case-control study. Cases were women who progressed to preeclampsia (n = 36), and controls were those who did not (n = 41). Serum sEng and UtAF measurements were performed at enrollment. The main outcomes measured were progression to preeclampsia and occurrence of preterm delivery (PD) <37 and <34 weeks of gestation, small for gestational age infant (SGA), and fetal growth restriction (FGR). Results: Women with sEng values in the highest tertile had higher risk of progression to preeclampsia, preterm delivery <34 weeks of gestation, and fetal growth restriction, odds ratios (ORs) ≥3.7. Patients with abnormal UtAF Doppler-pulsatility index had higher risk of progression to preeclampsia, preterm delivery <34 weeks of gestation, small for gestational age infant, and fetal growth restriction (ORs ≥3.3). The presence of notch was associated with higher risk of progression to preeclampsia, preterm delivery <37 and <34 weeks of gestation, SGA infant, and fetal growth restriction (ORs ≥2.9). However, logistic regression analysis revealed that only serum sEng was a significant and independent risk factor for progression of GH to preeclampsia, preterm delivery <34 weeks of gestation, and fetal growth restriction (ORs ≥3.1). Conclusions: In GH pregnancies, UtAF Doppler ultrasonography is associated with increased risk of adverse outcomes and progression to preeclampsia. However, serum sEng concentration appears to be a better predictor to assess the risk of adverse maternal and perinatal outcomes and progression to preeclampsia.

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“…Yang et al studied 2039 singleton pregnancies and uterine artery Doppler was done at 21 weeks of gestation and PI showed sensitivity of 83.8%, specificity of 91.9%, positive predictive value-49.1% and negative predictive value of 79.5% for predicting the risk of HDP 17. …”

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confidence: 99%

Role of uterine artery doppler at 18-22 weeks in the prediction of pre-eclampsia: a prospective study

Manjeera

Pereira

2020

Int J Reprod Contracept Obstet Gynecol

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Background: Pre-eclampsia is the most common pregnancy complication associated with serious maternal and fetal morbidity. Uterine artery Doppler reflects the impaired trophoblastic invasion of the uterine spiral arteries, which is involved in the aetiology of preeclampsia. Thus, uterine artery Doppler was proposed as a screening test for pre-eclampsia.Methods: A prospective cohort study of 100 singleton pregnancies was conducted in a tertiary centre and the study population were subjected to uterine artery Doppler study at 18-22 weeks gestation. Uterine artery Doppler indices of pulsatility index (PI), resistance index (RI) and persistence of diastolic notch was obtained and the outcome of pre-eclampsia was studied.Results: Out of 100 women, 14 women developed pre-eclampsia in which the resistance index showed a sensitivity of 21.4%, specificity of 91.8%, positive predictive value of 30% and negative predictive value of 87.7% and pulsatility index showed sensitivity of 35.7%, specificity of 90.6%, positive predictive value of 38.4% and negative predictive value of 89.6%. Diastolic notch had a sensitivity of 35.7%, specificity of 98.8%, positive predictive value of 83.3% and a negative predictive value of 90.4%.Conclusions: The high negative predictive values, indicated that women with normal Doppler velocimetry were unlikely to develop preeclampsia. Uterine artery Doppler, being non-invasive can be included during routine sonography to identify patients at risk of developing pre-eclampsia. Early, screening for pre-eclampsia will help in individualized antenatal surveillance and initiation of prophylactic therapy, early to reduce the adverse maternal and foetal complications of preeclampsia.

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Usefulness of uterine artery Doppler velocimetry as a predictor for hypertensive disorders in pregnancy in women with prehypertension before 20 weeks gestation

Cited by 9 publications

References 29 publications

Maternal and perinatal outcomes according to blood pressure levels for prehypertension: A review and meta-analysis

Maternal and perinatal outcomes according to blood pressure levels for prehypertension: A review and meta-analysis

Soluble Endoglin and Uterine Artery Flow Doppler Ultrasonography as Markers of Progression to Preeclampsia in Women with Gestational Hypertension

Role of uterine artery doppler at 18-22 weeks in the prediction of pre-eclampsia: a prospective study

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