[The relative weight of Doppler of the uterine artery and 24-h ambulatory blood pressure monitoring in predicting hypertension in pregnancy and preeclampsia].
OBJECTIVE
To assess the combined use and the "relative weight" of Uterine Artery Doppler Velocimetry and 24-h Ambulatory Blood Pressure Monitoring (ABPM) to predict Gestational Hypertension (GH) and Preeclampsia (PE).


METHODS
The predictivity of Doppler of uterine artery flow at 24 weeks and of ABPM at 24-30 weeks was assessed in 75 normotensive primigravidae, considering the subsequent onset of GH and/or PE.


RESULTS
In our series the sensitivity of Doppler versus GH is 62%, and 57% vs PE. The altered ABPM shows a sensitivity of 97% vs GH and 99% vs PE. In the cases with the both tests positive it was 97% vs GH, and 99% vs PE. In the subgroup of patients with altered Doppler velocimetry and normal ABPM, the sensitivity vs GH and PE is 12% (PPV = 12%). A second subgroup with normal Doppler velocimetry and altered ABPM shows a sensitivity of 94% vs GH (PPV = 88%), and 99% vs PE (PPV = 33%).


CONCLUSIONS
Uterine Artery Doppler Velocimetry and 24-h Ambulatory Blood Pressure Monitoring (ABPM) have a good predictive power for GH and PE, but the combined use improves the efficacy to identify an abnormal outcome of pregnancy. When evaluating for relative weight, the ABPM is more powerful in predicting for GH and PE than Doppler assessment. However, the high specificity of Doppler velocimetry reduces the false-positive ratio in the combined screening during the 2nd trimester of pregnancy.
Tranquilli
A L
AL
Clinica Ostetrica e Ginecologica, Università degli Studi di Ancona. tranquilli@popcsi.unian.it
Giannubilo
S R
SR
Bezzeccheri
V
V
Garbati
E
E
D000328:Adult; D001158:Arteries; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D017078:Laser-Doppler Flowmetry; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014599:Uterus