Sammya Bezerra Maia E Holanda Moura1,2, Paulo Cesar Praciano1, Julio Augusto Gurgel Alves1, Wellington P Martins3, Edward Araujo Júnior4, Stefan C Kane5,6, Fabrício da Silva Costa7,8,9. 1. Department of Public Health, State University of Ceará, Fortaleza, Brazil. 2. Science Health Department, Medicine Course, University of Fortaleza, Fortaleza, Brazil. 3. Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. 4. Department of Obstetrics, Paulista School of Medicine, São Paulo Federal University, São Paulo, Brazil. 5. Department of Obstetrics and Gynecology, University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia. 6. Pregnancy Research Center, Royal Women's Hospital, Parkville, Victoria, Australia. 7. Department of Obstetrics and Gynecology, University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia fabricio.costa@thewomens.org.au. 8. Pregnancy Research Center, Royal Women's Hospital, Parkville, Victoria, Australia fabricio.costa@thewomens.org.au. 9. Monash Ultrasound for Women, Melbourne, Victoria, Australia fabricio.costa@thewomens.org.au.
Abstract
OBJECTIVES: The purpose of this study was to examine whether the maternal renal interlobar vein impedance index as assessed by first-trimester sonography is able to predict the later development of hypertensive disorders of pregnancy. METHODS: Venous Doppler parameters of both maternal kidneys were studied in 214 pregnant women at gestational ages of 11 weeks to 13 weeks 6 days. Patients were classified according to outcomes related to hypertensive disorders. Detection rates and areas under receiver operating characteristic curves were determined for the maternal renal interlobar vein impedance index as a first-trimester predictor of preeclampsia and gestational hypertension. RESULTS: Among the 214 patients, 22 (10.3%) developed preeclampsia; 10 (4.7%) developed gestational hypertension; and 182 were unaffected by hypertensive disorders (controls; 85.0%). In the overall study population, there was no difference in the impedance index between the right (0.44; 95% confidence interval, 0.35-0.50) and left (0.43; 95% confidence interval, 0.35-0.53) sides (P = .86). The average impedance index did not differ among women destined to develop preeclampsia (0.46; 95% confidence interval, 0.38-0.57), gestational hypertension (0.39; 95% confidence interval, 0.33-0.46), or pregnancies uncomplicated by hypertensive disease (0.42; 95% confidence interval, 0.37-0.50; P = .15). Low detection rates and the area under the curve analysis demonstrated that the impedance index was not predictive of hypertensive disorders of pregnancy. CONCLUSIONS: The maternal renal interlobar vein impedance index should not be considered a first-trimester marker of hypertensive disorders of pregnancy.
OBJECTIVES: The purpose of this study was to examine whether the maternal renal interlobar vein impedance index as assessed by first-trimester sonography is able to predict the later development of hypertensive disorders of pregnancy. METHODS: Venous Doppler parameters of both maternal kidneys were studied in 214 pregnant women at gestational ages of 11 weeks to 13 weeks 6 days. Patients were classified according to outcomes related to hypertensive disorders. Detection rates and areas under receiver operating characteristic curves were determined for the maternal renal interlobar vein impedance index as a first-trimester predictor of preeclampsia and gestational hypertension. RESULTS: Among the 214 patients, 22 (10.3%) developed preeclampsia; 10 (4.7%) developed gestational hypertension; and 182 were unaffected by hypertensive disorders (controls; 85.0%). In the overall study population, there was no difference in the impedance index between the right (0.44; 95% confidence interval, 0.35-0.50) and left (0.43; 95% confidence interval, 0.35-0.53) sides (P = .86). The average impedance index did not differ among women destined to develop preeclampsia (0.46; 95% confidence interval, 0.38-0.57), gestational hypertension (0.39; 95% confidence interval, 0.33-0.46), or pregnancies uncomplicated by hypertensive disease (0.42; 95% confidence interval, 0.37-0.50; P = .15). Low detection rates and the area under the curve analysis demonstrated that the impedance index was not predictive of hypertensive disorders of pregnancy. CONCLUSIONS: The maternal renal interlobar vein impedance index should not be considered a first-trimester marker of hypertensive disorders of pregnancy.
Authors: Estela Blanco; Marcela Marin; Loreto Nuñez; Erika Retamal; Ximena Ossa; Katherine E Woolley; Tosin Oludotun; Suzanne E Bartington; Juana Maria Delgado-Saborit; Roy M Harrison; Pablo Ruiz-Rudolph; María Elisa Quinteros Journal: Rev Panam Salud Publica Date: 2022-05-02