Author(s): Onwudiwe N, Yu CK, Poon LC, Spiliopoulos I, Nicolaides KH
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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. (c) 2008 ISUOG.
This article was published in Ultrasound Obstet Gynecol
and referenced in Journal of Addiction Research & Therapy