Objectives: To assess the correlation between mean artery pulsatility index (UtA PI), measured at diagnosis of pre-eclampsia (PE), gestational age (GA) at delivery, and birth weight (BW) percentile. To assess the predictive value of mean UtA PI for the development of adverse pregnancy outcome (APO). Methods: Cohort study on 100 consecutive singleton pregnancies complicated with PE referred to our Department (2010–2011). Mean UtA PI values obtained at the time of diagnosis of PE were analysed. Clinical and perinatal outcomes were reviewed. APO was defined as one of the following: Apgar score < 7 at five minutes; pH < 7.20; birth weight < 5th percentile (SGA), stillbirth or neonatal death. Receiver-operating characteristics (ROC) curve calculated to determine the predictive ability for subsequent development of APO. Results: Median maternal age was 32 years (IQR 27–37 yrs), maternal BMI 21.9 kg/mq (IQR19.9–26.6 kg/mq), GA at diagnosis was 31 w (IQR 29+3–32+1), GA at delivery was 34+1 w (IQR 32+2–36+2 w), BW was 1629 g (IQR 1380–2050), BW percentile was 2.6th (0.5th – 8.9th ), pH was 7.27 (IQR 7.23 – 7.29). Fifty-six pregnancies developed APO. One case of stillbirth and four cases of neonatal death were observed. SGA occurred in 56/100 neonates. Mean ± SD UtA PI at diagnosis of PE was 1.40 ± 0.28 in women that developed APO and 1.10 ± 0.41 in women that did not develop APO (P = 0.02). There was a significant negative correlation between mean UtA PI and GA at delivery (r = −0.533, P = 0.002), and between mean UtA PI and BW percentile (r = −0.466, P = 0.007). The prediction of the subsequent development of APO, expressed as the area under ROC curve, was 61.6 (95% CI 0.44–0.79) for UtA PI at diagnosis of PE. Conclusions: Our data confirm that mean UtA PI, assessed at diagnosis of PE, represent a good independent predictor for GA at delivery and BW percentile. However the predictive value for the subsequent development of APO does not seem to be clinically relevant.
The role of Uterine Artery Pulsatility index for prediction of outcome in pregnancies complicated by pre-eclampsia
FICHERA, Anna;PAGANI, Giorgio;GEROSA, Vera;GREGORINI, Maria Elena;ROVIDA, Paola Linda;PREFUMO, FEDERICO;FRUSCA, Tiziana
2012-01-01
Abstract
Objectives: To assess the correlation between mean artery pulsatility index (UtA PI), measured at diagnosis of pre-eclampsia (PE), gestational age (GA) at delivery, and birth weight (BW) percentile. To assess the predictive value of mean UtA PI for the development of adverse pregnancy outcome (APO). Methods: Cohort study on 100 consecutive singleton pregnancies complicated with PE referred to our Department (2010–2011). Mean UtA PI values obtained at the time of diagnosis of PE were analysed. Clinical and perinatal outcomes were reviewed. APO was defined as one of the following: Apgar score < 7 at five minutes; pH < 7.20; birth weight < 5th percentile (SGA), stillbirth or neonatal death. Receiver-operating characteristics (ROC) curve calculated to determine the predictive ability for subsequent development of APO. Results: Median maternal age was 32 years (IQR 27–37 yrs), maternal BMI 21.9 kg/mq (IQR19.9–26.6 kg/mq), GA at diagnosis was 31 w (IQR 29+3–32+1), GA at delivery was 34+1 w (IQR 32+2–36+2 w), BW was 1629 g (IQR 1380–2050), BW percentile was 2.6th (0.5th – 8.9th ), pH was 7.27 (IQR 7.23 – 7.29). Fifty-six pregnancies developed APO. One case of stillbirth and four cases of neonatal death were observed. SGA occurred in 56/100 neonates. Mean ± SD UtA PI at diagnosis of PE was 1.40 ± 0.28 in women that developed APO and 1.10 ± 0.41 in women that did not develop APO (P = 0.02). There was a significant negative correlation between mean UtA PI and GA at delivery (r = −0.533, P = 0.002), and between mean UtA PI and BW percentile (r = −0.466, P = 0.007). The prediction of the subsequent development of APO, expressed as the area under ROC curve, was 61.6 (95% CI 0.44–0.79) for UtA PI at diagnosis of PE. Conclusions: Our data confirm that mean UtA PI, assessed at diagnosis of PE, represent a good independent predictor for GA at delivery and BW percentile. However the predictive value for the subsequent development of APO does not seem to be clinically relevant.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
