OBJECTIVES: To examine the performance of screening for hypertensive disorders in pregnancy at 11-13 weeks by a combination of the maternal history, uterine artery Doppler imaging and blood pressure. METHODS: This was a prospective screening study for pre-eclampsia (PE) requiring delivery before 34 weeks (early PE), late PE and gestational hypertension (GH) in women attending for their routine first hospital visit in pregnancy at 11 + 0 to 13 + 6 weeks of gestation. Maternal history was recorded, color flow Doppler imaging was used to identify the uterine artery with the lowest pulsatility index (L-PI) and automated devices were used to measure the mean arterial pressure (MAP). The performance of screening for PE and GH by a combination of the maternal factor-derived a-priori risk, the uterine artery L-PI and MAP was determined. RESULTS: There were 8061 (96.4%) cases unaffected by PE or GH, 165 (2.0%) that developed PE including 37 that required delivery before 34 weeks (early PE) and 128 with late PE, and 140 (1.7%) that developed GH. The MAP was higher in early PE, late PE and GH than in the unaffected group (P < 0.0001), and in early PE than in GH (P = 0.002). The uterine artery L-PI was significantly higher in early PE and late PE than in the unaffected group (P < 0.0001), in early PE than late PE or GH (P < 0.0001), and in GH than in the unaffected group (P = 0.014). In screening by a combination of the maternal factor-derived a-priori risk, uterine artery L-PI and MAP, the estimated detection rate at a 10% false-positive rate was 89.2% (95% CI, 74.6-96.9%) for early PE, 57.0% (95% CI, 48.0-65.7%) for late PE and 50.0% (95% CI, 41.4-58.6%) for GH. CONCLUSIONS: Effective screening for hypertensive disorders in pregnancy is provided by a combination of maternal history, uterine artery Doppler imaging and blood pressure at 11-13 weeks. (c) 2009 ISUOG. Published by John Wiley & Sons, Ltd.
OBJECTIVES: To examine the performance of screening for hypertensive disorders in pregnancy at 11-13 weeks by a combination of the maternal history, uterine artery Doppler imaging and blood pressure. METHODS: This was a prospective screening study for pre-eclampsia (PE) requiring delivery before 34 weeks (early PE), late PE and gestational hypertension (GH) in women attending for their routine first hospital visit in pregnancy at 11 + 0 to 13 + 6 weeks of gestation. Maternal history was recorded, color flow Doppler imaging was used to identify the uterine artery with the lowest pulsatility index (L-PI) and automated devices were used to measure the mean arterial pressure (MAP). The performance of screening for PE and GH by a combination of the maternal factor-derived a-priori risk, the uterine artery L-PI and MAP was determined. RESULTS: There were 8061 (96.4%) cases unaffected by PE or GH, 165 (2.0%) that developed PE including 37 that required delivery before 34 weeks (early PE) and 128 with late PE, and 140 (1.7%) that developed GH. The MAP was higher in early PE, late PE and GH than in the unaffected group (P < 0.0001), and in early PE than in GH (P = 0.002). The uterine artery L-PI was significantly higher in early PE and late PE than in the unaffected group (P < 0.0001), in early PE than late PE or GH (P < 0.0001), and in GH than in the unaffected group (P = 0.014). In screening by a combination of the maternal factor-derived a-priori risk, uterine artery L-PI and MAP, the estimated detection rate at a 10% false-positive rate was 89.2% (95% CI, 74.6-96.9%) for early PE, 57.0% (95% CI, 48.0-65.7%) for late PE and 50.0% (95% CI, 41.4-58.6%) for GH. CONCLUSIONS: Effective screening for hypertensive disorders in pregnancy is provided by a combination of maternal history, uterine artery Doppler imaging and blood pressure at 11-13 weeks. (c) 2009 ISUOG. Published by John Wiley & Sons, Ltd.
Authors: Mark K Santillan; Donna A Santillan; Sabrina M Scroggins; James Y Min; Jeremy A Sandgren; Nicole A Pearson; Kimberly K Leslie; Stephen K Hunter; Gideon K D Zamba; Katherine N Gibson-Corley; Justin L Grobe Journal: Hypertension Date: 2014-07-07 Impact factor: 10.190
Authors: Anne Sørensen; Marianne Sinding; David A Peters; Astrid Petersen; Jens B Frøkjær; Ole B Christiansen; Niels Uldbjerg Journal: Physiol Rep Date: 2015-10
Authors: Lesley M E McCowan; John M D Thompson; Rennae S Taylor; Robyn A North; Lucilla Poston; Philip N Baker; Jenny Myers; Claire T Roberts; Gustaaf A Dekker; Nigel A B Simpson; James J Walker; Louise C Kenny Journal: PLoS One Date: 2013-08-05 Impact factor: 3.240