Obstet Gynecol Sci.  2019 Nov;62(6):391-396. 10.5468/ogs.2019.62.6.391.

Prediction of preeclampsia in the first trimester of pregnancy using maternal characteristics, mean arterial pressure, and uterine artery Doppler data in a Brazilian population

• Leite JD
• Lobo GA
• Nowak PM
• Antunes IR
• Araujo Júnior E
• Pares DB

• KMID: 2462116
• DOI: http://doi.org/10.5468/ogs.2019.62.6.391

Abstract

OBJECTIVE
To evaluate the performance of the preeclampsia (PE) screening algorithm of the Fetal Medicine Foundation (FMF) during the first trimester in a Brazilian population using maternal characteristics, mean arterial pressure (MAP), and uterine artery Doppler data.
METHODS
This is a prospective cohort study that evaluated 701 pregnant women during the first trimester ultrasound screening for chromosomal abnormalities (11-13+6 weeks). All patients provided information regarding clinical and obstetric history, MAP, and mean uterine artery pulsatility index (mean PI). Patients were assigned to four groups based on the presence of PE and gestational age at delivery: group 1 (control), patients without hypertensive disorders (n=571); group 2, PE and delivery before 34 weeks of gestation (n=7); group 3, PE and delivery before 37 weeks of gestation, including patients from group 2 and patients that presented PE with delivery between 34 and 37 weeks (n=17); and group 4, PE and delivery before 42 weeks of gestation, including patients from both groups 2 and 3 and patients that presented PE with delivery between 37 and 42 weeks of gestation (n=34).
RESULTS
After the exclusion of 96 patients, we evaluated the data of 605 patients. By combining maternal characteristics, MAP, and the mean uterine artery PI for the detection of PE, we found a sensitivity of 71.4% in group 2, 50% in group 3, and 41.2% in group 4 (false positive rate=10%).
CONCLUSION
Using maternal characteristics, MAP, and uterine artery Doppler data, we were able to identify a significant proportion of patients who developed preterm PE.

Keyword

Preeclampsia; Prediction; First trimester; Mean artery pressure; Uterine artery Doppler

MeSH Terms

Arterial Pressure*
Chromosome Aberrations
Cohort Studies
Female
Gestational Age
Humans
Mass Screening
Pre-Eclampsia*
Pregnancy
Pregnancy Trimester, First*
Pregnancy*
Pregnant Women
Prospective Studies
Ultrasonography
Uterine Artery*

Figure

• 

  Fig. 1 Screening and follow up of the included patients on the study. ASA, acetylsalicylic acid; PE, preeclampsia.

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  Fig. 2 Receiver operating characteristics curve for preeclampsia prediction in the first trimester using the combination of the following variables: maternal characteristics, mean artery pressure and uterine artery Doppler.

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