Low maternal middle cerebral artery Doppler resistance indices can predict future development of pre-eclampsia

M. Belfort*, T. Van Veen, G. L. White, S. Kofford, J. Allred, I. Postma, M. Varner

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

15 Citations (Scopus)

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 receiveroperating 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 (c) 2012 ISUOG. Published by John Wiley & Sons, Ltd.

Original languageEnglish
Pages (from-to)406-411
Number of pages6
JournalUltrasound in Obstetrics & Gynecology
Volume40
Issue number4
DOIs
Publication statusPublished - Oct-2012

Keywords

  • cerebrovascular resistance
  • pre-eclampsia prediction
  • pulsatility index
  • resistance index
  • transcranial ultrasound
  • UTERINE PERFUSION-PRESSURE
  • BLOOD-FLOW VELOCITY
  • TRANSCRANIAL DOPPLER
  • NORMAL-PREGNANCY
  • WOMEN
  • HEMODYNAMICS
  • HYPERTENSION
  • ULTRASOUND
  • DISEASE

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