Low maternal middle cerebral artery Doppler resistance indices can predict future development of pre-eclampsia

Autor: Shalece Kofford, Ineke R. Postma, Janalee Allred, Michael A. Belfort, T R van Veen, G. L. White, Michael W. Varner
Přispěvatelé: Faculteit Medische Wetenschappen/UMCG
Rok vydání: 2011
Předmět:
Middle Cerebral Artery
pre-eclampsia prediction
Hemodynamics
Blood Pressure
DISEASE
Pre-Eclampsia
TRANSCRANIAL DOPPLER
Pregnancy
Medicine
Ultrasonography
Doppler
Color
ULTRASOUND
BLOOD-FLOW VELOCITY
education.field_of_study
Radiological and Ultrasound Technology
Pregnancy Outcome
WOMEN
Obstetrics and Gynecology
General Medicine
UTERINE PERFUSION-PRESSURE
Vasodilation
medicine.anatomical_structure
HEMODYNAMICS
Anesthesia
Pregnancy Trimester
Second
Middle cerebral artery
Cardiology
Female
cerebrovascular resistance
Blood Flow Velocity
Adult
medicine.medical_specialty
Population
transcranial ultrasound
NORMAL-PREGNANCY
Sensitivity and Specificity
Ultrasonography
Prenatal
resistance index
Predictive Value of Tests
Internal medicine
medicine.artery
Humans
pulsatility index
Radiology
Nuclear Medicine and imaging
Cerebral perfusion pressure
education
Eclampsia
HYPERTENSION
business.industry
Infant
Newborn
medicine.disease
Transcranial Doppler
Blood pressure
Reproductive Medicine
ROC Curve
Vascular resistance
Vascular Resistance
business
Zdroj: Ultrasound in Obstetrics & Gynecology, 40(4), 406-411. Wiley
ISSN: 1469-0705
0960-7692
Popis: Objective To determine if decreased resistance (vasodilatation) in the maternal middle cerebral artery (MCA) in the second trimester can predict third-trimester development of pre-eclampsia. Methods Four-hundred and five low-risk gravidas had MCA transcranial Doppler (TCD) once in the second trimester. Maternal/neonatal outcomes were evaluated after delivery. Mean blood pressure, MCA velocities, resistance index (RI), pulsatility index (PI) and cerebral perfusion pressure (CPP) were compared between normotensive and pre-eclamptic cohorts. Results Seven subjects (1.7%) developed pre-eclampsia. An RI of < 0.54 and a PI of < 0.81 were clinically useful in predicting subsequent pre-eclampsia. Areas under the receiver–operating characteristics curves for RI and PI were 0.93 and 0.93, respectively, with optimal sensitivity and specificity of 86% and 93% for both variables. Positive and negative likelihood ratios were 11.8/0.15 (RI) and 12.3/0.15 (PI). Conclusion TCD indices of low maternal MCA resistance in the second trimester are predictive of the subsequent development of pre-eclampsia in a low-risk, ethnically homogeneous population. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Databáze: OpenAIRE
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