Longitudinal changes in uterine artery Doppler and blood pressure and risk of pre‐eclampsia

Abstract

Objective To investigate longitudinal changes in the uterine artery mean pulsatility index (UtA-PI) UtA-PI and MAP in normal pregnancies and in women who develop PE and GH. Conclusion The study describes temporal changes in

Longitudinal changes in maternal hemodynamics in a population at risk for pre‐eclampsia

“…Concerning the same cohort, we previously reported in the normotensive group a U‐shaped relationship between mean arterial pressure (MAP) and gestational age, with a nadir at c . 24 weeks. It is notable that the changes in SBPao we report here seem to differ from those previously reported in peripheral (brachial) blood pressure.…”

“…24 weeks. It is notable that the changes in SBPao we report here seem to differ from those previously reported in peripheral (brachial) blood pressure. However, this is consistent with studies in non‐pregnant patients which found that central and peripheral blood pressures are not synonymous.…”

Role of uteroplacental and fetal Doppler in identifying fetal growth restriction at term

“…Conventionally, uterine artery Doppler indices have been measured in the second trimester when increased resistance has been taken as an indicator of impaired trophoblastic invasion of the maternal spiral arteries, and associated with an increased risk of later pregnancy complications due to placental dysfunction, such as preeclampsia, SGA and FGR [33][34][35]. It has also been demonstrated that uterine artery Doppler indices at the end of the first trimester may also predict preeclampsia, FGR, placental abruption and stillbirth, although with less sensitivity and specificity than second trimester measures [33][34][35][36][37][38][39].…”

“…It has also been demonstrated that uterine artery Doppler indices at the end of the first trimester may also predict preeclampsia, FGR, placental abruption and stillbirth, although with less sensitivity and specificity than second trimester measures [33][34][35][36][37][38][39]. More recently, longitudinal studies have reported progressive deterioration of uterine artery Doppler indices in women who go on to develop preeclampsia [34]. This has led to a shift in emphasis from a single point assessment to monitoring the longitudinal trend.…”

Uterine artery Doppler longitudinal changes in pregnancies complicated with intrauterine growth restriction without preeclampsia

“…A similar study design has been recently published by Khalil et al . ; however, in this study the longitudinal changes in UtAs were considered in a different setting (patients at high risk for PE at first trimester screening) and analyzed in function of the occurrence of hypertensive disorders and not IUGR. Moreover, although our cases also showed higher UtA‐PI values compared with controls from early pregnancy onward, (the gap increasing with gestational age) we decided to use only linear models in order to not have to deal with the problem of reproducibility of squared and cubic terms to define the polynomial association between UtA‐PI and gestational age as instead reported in the Khalil paper.…”