title: Maternal history and uterine artery Doppler in the assessment of risk for development of early- and late-onset preeclampsia and intrauterine growth restriction.
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.
authors: Department of Obstetrics, Fetal Medicine Unit, Vall d'Hebron Hospital, Universitat Autònoma de Barcelona, 08035-Barcelona, Spain.
authors: Elisa
authors: E
authors: Llurba
authors: Elena
authors: E
authors: Carreras
authors: Eduard
authors: E
authors: Gratacós
authors: Miquel
authors: M
authors: Juan
authors: Judith
authors: J
authors: Astor
authors: Angels
authors: A
authors: Vives
authors: Eduard
authors: E
authors: Hermosilla
authors: Ines
authors: I
authors: Calero
authors: Pilar
authors: P
authors: Millán
authors: Bárbara
authors: B
authors: García-Valdecasas
authors: Lluís
authors: L
authors: Cabero