Prediction of pre-eclampsia by a combination of maternal history, uterine artery Doppler and mean arterial pressure

Authors


Abstract

Objectives

To determine the value of combined screening for pre-eclampsia by maternal history, and mid-trimester uterine artery (UtA) Doppler imaging and maternal blood pressure.

Methods

In 3529 singleton pregnancies attending for routine care at 22–24 weeks' gestation we recorded maternal variables, and made UtA Doppler and mean arterial pressure (MAP) measurements. Multiple regression analysis was used to determine the significant predictors of pre-eclampsia, gestational hypertension and small-for-gestational age (SGA) among maternal characteristics, UtA pulsatility index (PI) and MAP.

Results

Complete pregnancy outcomes were available in 3359/3529 (95.2%) cases. Pre-eclampsia developed in 101 (3.0%) pregnancies, including 23 (0.7%) in which delivery was before 34 weeks (early pre-eclampsia) and 78 (2.3%) with delivery at 34 weeks or more (late pre-eclampsia); 74 (2.2%) developed gestational hypertension, 366 (10.9%) delivered SGA newborns with no hypertensive disorders, and 2806 (83.8%) were unaffected by pre-eclampsia, gestational hypertension or SGA. Multiple regression analysis demonstrated that maternal characteristics, UtA-PI and MAP provided a significant independent contribution in the prediction of pre-eclampsia, gestational hypertension and SGA. For a false-positive rate of 10%, the estimated detection rates of early and late pre-eclampsia were 100% and 56.4%, respectively.

Conclusions

The combination of maternal demographic characteristics, and UtA Doppler and maternal blood pressure measurements is an effective screening tool for the prediction of pre-eclampsia. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.

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