Uterine artery velocimetry in patients with gestational hypertension

Frusca, T.; Soregaroli, Mirella; Platto, C.; Enterri, L.; Lojacono, Andrea; Valcamonico, Adriana

doi:10.1016/s0029-7844(03)00360-0

Cited by 27 publications

(25 citation statements)

References 14 publications

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“…Previous studies examining uterine artery PI [29,30,31,32,33] and serum PlGF or the sFlt-1 to PlGF ratio [34,35,36,37,38,39] in the late second or early third trimesters of pregnancy have essentially focused on the investigation of women presenting to specialist clinics with signs of hypertensive disorders with the aim of identifying the subgroup that will develop severe disease [29,30,31,32,33,34]. Our study examined the application of biomarkers in routine screening for subsequent development of PE as part of a strategy for a new approach to prenatal care [7].…”

Section: Discussionmentioning

confidence: 99%

Competing Risks Model in Screening for Preeclampsia by Biophysical and Biochemical Markers at 30-33 Weeks' Gestation

et al. 2014

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Objective: To assess the risk for preeclampsia (PE) by maternal characteristics, uterine artery pulsatility index (Ut-PI), mean arterial pressure (MAP), serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1)at 30-33 weeks' gestation. Methods: This was a screening study in singleton pregnancies including 2,140 that developed PE and 83,615 that were unaffected by PE. We developed a survival time model for the time of delivery for PE by combining maternal characteristics and history with Ut-PI, MAP, PlGF and sFlt-1 multiple of the median (MoM) values (combined test). Data on third-trimester MAP and Ut-PI were available in 350 cases of PE, and 13,878 unaffected pregnancies and data on PlGF and sFlt-1 were available in 118 cases of PE and 3,734 unaffected pregnancies. Modelled detection rate of all PE and PE requiring delivery within 4 and 6 weeks of the visit was estimated. Results: Screening by the combined test would detect 66, 98 and 86% of all PE and PE requiring delivery within 4 and 6 weeks of the visit, respectively, at a false positive rate of 5%. Interpretation: Screening by biophysical and biochemical testing at 30-33 weeks could identify most pregnancies developing PE and requiring delivery within the subsequent 4 weeks.

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Section: Discussionmentioning

confidence: 99%

Competing Risks Model in Screening for Preeclampsia by Biophysical and Biochemical Markers at 30-33 Weeks' Gestation

et al. 2014

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“…Essentially, Doppler studies were carried out in pregnancies presenting with PE or fetal growth restriction reported that the outcome was worse if there was increased, rather than normal, impedance to flow in the uterine arteries [16,17,18,19,20,21,22]. Similarly, studies investigating pregnancies with abnormal uterine artery Doppler at 20-24 weeks' gestation reported that outcome was worse in those with persistence of high impedance to flow during the third trimester compared to those with normalization in flow [23,24,25].…”

Section: Introductionmentioning

confidence: 99%

Uterine Artery Doppler at 30-33 Weeks' Gestation in the Prediction of Preeclampsia

Lai¹,

Poon²,

Pinas³

et al. 2013

Fetal Diagn Ther

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Objective: To investigate the potential value of measuring uterine artery pulsatility index (PI) at 30-33 weeks' gestation in the prediction of preeclampsia (PE) developing at or after 34 weeks. Methods: Screening study in singleton pregnancies at 30-33 weeks' gestation including 4,294 cases that were unaffected by PE, gestational hypertension (GH) or delivery of small for gestational age neonates (normal group), 145 that subsequently developed PE, with 37 cases requiring delivery at 34-37 weeks (intermediate-PE) and 108 delivering at or after 38 weeks (late-PE) and 161 that developed GH. The a priori risks for intermediate- and late-PE from maternal demographic characteristics and medical history were derived by logistic regression analysis. The a posteriori risks were calculated by combining the a priori risks with the likelihood ratios for uterine artery PI, which were calculated from fitted bivariate gaussian distributions. Results: In screening for PE by a combination of maternal characteristics and uterine artery PI, the estimated detection rates of intermediate- and late-PE, at a false-positive rate of 10%, were 70.3 and 54.6%, respectively. Conclusion: Combined testing by maternal characteristics and uterine artery PI at 30-33 weeks could effectively identify women at high risk for subsequent development of PE.

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“…Previous uterine artery Doppler studies during the third-trimester examined pregnancies presenting with PE or fetal growth restriction and reported that the outcome was worse if impedance to flow was increased [20,21,22,23,24,25,26]. Two previous screening studies at 30-33 weeks' gestation examined 4,855 pregnancies and reported that at FPR of 5% screening by a combination of maternal characteristics and uterine artery PI or MAP detected 49 and 57%, respectively, of intermediate PE requiring delivery at 34-37 weeks and 37 and 49% of late PE with delivery at ≥38 weeks [27,28].…”

Section: Discussionmentioning

confidence: 99%

Competing Risk Model in Screening for Preeclampsia by Mean Arterial Pressure and Uterine Artery Pulsatility Index at 30-33 Weeks' Gestation

Tayyar

Larroca²,

Poon

et al. 2014

Fetal Diagn Ther

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Objective: To assess risk for preeclampsia (PE) based on maternal characteristics, mean arterial pressure (MAP) and uterine artery pulsatility index (Ut-PI) at 30-33 weeks' gestation. Methods: Screening study in singleton pregnancies including 2,140 that subsequently developed PE and 83,615 that were unaffected by PE, gestational hypertension or delivery of small-for-gestational-age neonates (normal group). We developed a survival time model for the time of delivery for PE by combination of maternal characteristics and history with MAP and Ut-PI multiple of the median (MoM) values (biophysical test). Data on third-trimester MAP and Ut-PI were available in 350 cases of PE and 13,878 of the normal group. The detection rate of PE requiring delivery within 4, 6 and 8 weeks of the visit was estimated. Results: In pregnancies with PE the log₁₀ MoM values of MAP and Ut-PI were inversely related to gestational age at delivery. Biophysical testing detected 90, 65 and 53% of PE with delivery within 4, 6 and 8 weeks of the visit, at a fixed false-positive rate of 5%. Interpretation: Testing by maternal characteristics, Ut-PI and MAP at 30-33 weeks could identify 90% of pregnancies developing PE and requiring delivery within the subsequent 4 weeks.

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Uterine artery velocimetry in patients with gestational hypertension

Abstract: Abnormal uterine Doppler was the variable that was more frequently associated with adverse pregnancy outcome.

Cited by 27 publications

References 14 publications

Competing Risks Model in Screening for Preeclampsia by Biophysical and Biochemical Markers at 30-33 Weeks' Gestation

Competing Risks Model in Screening for Preeclampsia by Biophysical and Biochemical Markers at 30-33 Weeks' Gestation

Uterine Artery Doppler at 30-33 Weeks' Gestation in the Prediction of Preeclampsia

Competing Risk Model in Screening for Preeclampsia by Mean Arterial Pressure and Uterine Artery Pulsatility Index at 30-33 Weeks' Gestation

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