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Low maternal middle cerebral artery Doppler resistance indices can predict future development of pre‐eclampsia
Author(s) -
Belfort M.,
Van Veen T.,
White G. L.,
Kofford S.,
Allred J.,
Postma I.,
Varner M.
Publication year - 2012
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.11078
Subject(s) - medicine , middle cerebral artery , eclampsia , transcranial doppler , population , cardiology , vascular resistance , blood pressure , pulsatility index , cerebral perfusion pressure , pregnancy , obstetrics , cerebral blood flow , fetus , ischemia , environmental health , biology , genetics
Abstract Objective To determine if decreased resistance (vasodilatation) in the maternal middle cerebral artery (MCA) in the second trimester can predict third‐trimester development of pre‐eclampsia. Methods Four‐hundred and five low‐risk gravidas had MCA transcranial Doppler (TCD) once in the second trimester. Maternal/neonatal outcomes were evaluated after delivery. Mean blood pressure, MCA velocities, resistance index (RI), pulsatility index (PI) and cerebral perfusion pressure (CPP) were compared between normotensive and pre‐eclamptic cohorts. Results Seven subjects (1.7%) developed pre‐eclampsia. An RI of < 0.54 and a PI of < 0.81 were clinically useful in predicting subsequent pre‐eclampsia. Areas under the receiver–operating characteristics curves for RI and PI were 0.93 and 0.93, respectively, with optimal sensitivity and specificity of 86% and 93% for both variables. Positive and negative likelihood ratios were 11.8/0.15 (RI) and 12.3/0.15 (PI). Conclusion TCD indices of low maternal MCA resistance in the second trimester are predictive of the subsequent development of pre‐eclampsia in a low‐risk, ethnically homogeneous population. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.