Maternal History and Uterine Artery Doppler in the Assessment of Risk for Development of Early- and Late-Onset Preeclampsia and Intrauterine Growth Restriction
Llurba, Elisa (Hospital Universitari Vall d'Hebron)
Carreras Moratonas, Elena (Hospital Universitari Vall d'Hebron)
Gratacos, Eduard (Hospital Universitari Vall d'Hebron)
Juan Clar, Miquel (Hospital Universitari Son Llàtzer (Palma de Mallorca, Balears))
Astor, Judith (Hospital General de Granollers)
Vives, Àngels (Consorci Sanitari de Terrassa)
Hermosilla, Eduardo (Hospital Universitari Vall d'Hebron)
Calero Fernández, Inés (Hospital Universitari Vall d'Hebron)
Millán Ramírez, Pilar (Hospital Universitari Vall d'Hebron)
García-Valdecasas Vilanova, Bárbara (Hospital Universitari Vall d'Hebron)
Cabero i Roura, Lluís (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Date:	2009
Abstract:	Objective. To examine the value of one-step uterine artery Doppler at 20 weeks of gestation in the prediction pre-eclampsia (PE) and/or intrauterine growth restriction (IUGR). Methods. A prospective multicentre study that included all women with singleton pregnancies at 19-22 weeks of gestation (w). The mean pulsatility index (mPI) of both uterine arteries was calculated. Receiver-operating characteristics curves (ROC) were drawn to compare uterine artery Doppler and maternal risk factors for the prediction of early-onset PE and/or IUGR (before 32 w) and late-onset PE and/or IUGR. Results. 6,586 women were included in the study. Complete outcome data was recorded for 6,035 of these women (91. 6%). PE developed in 75 (1. 2%) and IUGR in 69 (1. 1%) cases. Uterine Doppler mPI was 0. 99 and the 90th centile was 1. 40. For 10% false-positive rate, uterine Doppler mPI identified 70. 6% of pregnancies that subsequently developed early-onset PE and 73. 3% of pregnancies that developed early-onset IUGR. The test had a lower detection rate for the late-onset forms of the disease (23. 5% for PE and 30% for IUGR). Maternal history has a low sensitivity in the detection of early-onset cases, although it is better at detecting late-onset PE. Conclusion. Uterine artery Doppler and maternal risk factors seem to select two different populations - early and late-onset PE which might suggest a different pathogenesis.
Grants:	Instituto de Salud Carlos III FIS/01-1397 Instituto de Salud Carlos III FIS/02-0742 Instituto de Salud Carlos III FIS/06-1213 Instituto de Salud Carlos III FIS/07-1095 Instituto de Salud Carlos III RETIC/RD08/0072
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Obstetrics and Gynecology International, Vol. 2009 (March 2009) , art. 275613, ISSN 1687-9597

DOI: 10.1155/2009/275613
PMID: 19936122

6 p, 553.3 KB

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