Hypertensive disorders in pregnancy: screening by uterine artery Doppler at 11–13 weeks
Key result
Screening by maternal factors combined with the lowest uterine artery pulsatility index increased the detection rate of early pre-eclampsia from 47% to 81% at a 10% false-positive rate.
Why the study?
Does combining maternal factor-derived a-priori risk with uterine artery pulsatility index improve the detection rate of hypertensive disorders in pregnancy compared to maternal factors alone?
Study Design
Type
Observational (n=8,366)
Structured PICO
Does combining maternal factor-derived a-priori risk with uterine artery pulsatility index improve the detection rate of hypertensive disorders in pregnancy compared to maternal factors alone?
P
Population
8,366 pregnant women attending their routine first hospital visit at 11 to 13 weeks of gestation, screened for pre-eclampsia and gestational hypertension.
E
Exposure
Screening using a combination of maternal factor-derived a-priori risk and uterine artery (UtA) pulsatility index (PI), specifically the lowest UtA-PI
C
Comparator
Screening by maternal factors alone
O
Outcome
Detection rate of early pre-eclampsia (PE), late PE, and gestational hypertension (GH) at a 10% false-positive ratesurrogate
Main Result
Absolute Event Rate: 81% vs 47%
Combining maternal risk factors with the lowest uterine artery pulsatility index at 11-13 weeks of gestation significantly improves the screening detection rate for early pre-eclampsia.
Authors
Discussion
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Implication
May enhance early pre-eclampsia screening; extends maternal factor models but leaves open prospective validation before practice change.
Cite This Study
Poon et al. (2009) conducted an observational in Hypertensive disorders in pregnancy (n=8,366). Screening by maternal factors and lowest uterine artery pulsatility index vs. Screening by maternal factors alone was evaluated on Detection rate of early pre-eclampsia at a 10% false-positive rate. Screening by maternal factors combined with the lowest uterine artery pulsatility index increased the detection rate of early pre-eclampsia from 47% to 81% at a 10% false-positive rate.