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Predictive value of ophthalmic artery Doppler velocimetry in relation to hypertensive disorders of pregnancy
Author(s) -
Matias Denise S.,
Santos Rebeca,
Ferreira Tatiana,
Matias Bruno S.,
Correia Luis Cláudio L.
Publication year - 2020
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22823
Subject(s) - medicine , receiver operating characteristic , preeclampsia , ophthalmic artery , gestational hypertension , cardiology , predictive value of tests , gestational age , diastole , area under the curve , likelihood ratios in diagnostic testing , confounding , pregnancy , velocimetry , umbilical artery , gestation , obstetrics , blood pressure , blood flow , optics , biology , genetics , physics
Purpose To test the predictive value of ophthalmic artery (OA) Doppler velocimetry in relation to the occurrence of hypertensive disorders of pregnancy (HDP). Methods We compared, by analysis of variance, the values of seven OA Doppler variables (peak systolic velocity, second systolic peak velocity [P2], mean velocity, end diastolic velocity, resistance index [RI], pulsatility index [PI], and peak ratio) of 31 women with preeclampsia and 33 women with gestational hypertension vs those of 227 women without HDP. The prognostic value of these variables in relation to the occurrence of HDP was evaluated by the area under the curve (AUC) receiver operating characteristic curve. Results All OA Doppler variables except RI and PI showed significant ( P < .5) differences between groups. After adjustment for confounders, only P2 was an independent predictor of HDP ( P < .001), with an AUC of 0.76. The best cut‐off point for predicting HDP was P2 ≥ 21.4 cm/s, with sensitivity 69%, specificity 78%, positive likelihood ratio 3.1, negative likelihood ratio 0.4, positive predictive value 47%, and negative predictive value 90%. P2 improved the predictive ability of a model based on clinical variables, incrementing AUC from 0.77 to 0.84 in the final model containing clinical and Doppler variables. Conclusion The elevation of OA P2 in the second trimester of pregnancy is an independent predictor of hypertensive disorders, and improves the discriminatory ability of clinical markers.