Pulse wave analysis: a preliminary study of a novel technique for the prediction of pre-eclampsia.
OBJECTIVE
To investigate whether first-trimester arterial pulse wave analysis (PWA) can predict pre-eclampsia.


METHODS
This was a prospective screening study.


METHODS
The Homerton University Hospital, a London teaching hospital.


METHODS
Two hundred and ten low-risk women with a singleton pregnancy were analysed.


METHODS
Radial artery pulse waveforms were measured between the 11(+0) and 13(+6) weeks of gestation and the aortic waveform derived by applying a generalised transfer function. Augmentation pressure (AP) and augmentation index at heart rate of 75 beats per minute (AIx-75), measures of arterial stiffness, were calculated. The multiple of the gestation-specific median in controls for AP and AIx-75 were calculated. Logistic regression models were developed and their predictive ability assessed using the area under the receiver operator curve.


METHODS
Prediction of pre-eclampsia by AIx-75.


RESULTS
Fourteen (6.7%) women developed pre-eclampsia, and 196 remained normotensive. Eight of the 14 women developed pre-eclampsia before 34 weeks of gestation (early-onset pre-eclampsia). For a false-positive rate of 11%, AIx-75 had a detection rate of 79% for all cases of pre-eclampsia and 88% for early-onset pre-eclampsia.


CONCLUSIONS
First-trimester arterial PWA can play a significant role in understanding the pathophysiology of pre-eclampsia and may play a role in early screening.
Khalil
A A
AA
Department of Obstetrics and Gynaecology, Queen Mary, University of London, and King's College Hospital, London, UK. asmakhalil79@googlemail.com
Cooper
D J
DJ
Harrington
K F
KF
D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000000981:diagnostic imaging; D008423:Maternal Age; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012372:ROC Curve; D017534:Radial Artery / Q000000981:diagnostic imaging*; D012815:Signal Processing, Computer-Assisted; D014463:Ultrasonography