Prediction of Pre‐Eclampsia at 18–24 Weeks of Gestation Using Maternal Ophthalmic Artery Doppler

To determine the discriminatory capacity of maternal ophthalmic artery (OA) Doppler parameters at 18-24 weeks of gestation for predicting pre-eclampsia (PE) in a south Indian population and to compare its predictive ability with known markers of pre-eclampsia like mean arterial pressure (MAP) and uterine artery pulsatility index (UtA-PI). This was a single-center prospective observational study of normotensive pregnant women presenting for routine ultrasound screening between 18 and 24 weeks of gestation. OA and UtA Doppler were performed on all enrolled participants who were followed up for subsequent development of PE. Detection rates (DR) at 10% false-positive rates (FPR) and the area under receiver operator characteristic (AUROC) curves were determined. The predictive ability of various OA and UtA Doppler indices was assessed in a multivariate regression model. The study included 408 pregnant women and 15 (3.68%, 95% CI: 2.24-5.97) of these participants subsequently developed PE. The OA peak systolic velocity (PSV) ratio was significantly associated with PE (P = .03) in the multivariate regression analysis. The mean OA PSV ratio had a 93.3% DR for a 10% FPR with AUROC of 0.98 (95% CI: 0.96-1) while the mean UtA-PI had a 67% DR for a 10% FPR with AUROC of 0.90 (95% CI: 0.86-0.95) in the prediction of PE. The OA PSV ratio was found to be superior to UtA-PI in the prediction of PE between 18 and 24 weeks of gestation, and this may be incorporated into routine diagnostic ultrasound, but larger studies are needed to validate this finding.