Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use
Preeclampsia is a pregnancy-specific disorder defined by new onset of hypertension and proteinuria after 20 weeks of gestation. The early detection of patients at risk of developing preeclampsia is crucial, however, predictive models are still controversial. We aim to evaluate the diagnostic perform...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-03-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/10/4/182 |
| _version_ | 1798006140094644224 |
|---|---|
| author | Max Mönckeberg Valentina Arias Rosario Fuenzalida Santiago Álvarez Victoria Toro Andrés Calvo Juan P. Kusanovic Lara J. Monteiro Manuel Schepeler Jyh K. Nien Jaime Martinez Sebastián E. Illanes |
| author_facet | Max Mönckeberg Valentina Arias Rosario Fuenzalida Santiago Álvarez Victoria Toro Andrés Calvo Juan P. Kusanovic Lara J. Monteiro Manuel Schepeler Jyh K. Nien Jaime Martinez Sebastián E. Illanes |
| author_sort | Max Mönckeberg |
| collection | DOAJ |
| description | Preeclampsia is a pregnancy-specific disorder defined by new onset of hypertension and proteinuria after 20 weeks of gestation. The early detection of patients at risk of developing preeclampsia is crucial, however, predictive models are still controversial. We aim to evaluate the diagnostic performance of a predictive algorithm in the first trimester of pregnancy, in order to identify patients that will subsequently develop preeclampsia, and to study the effect of aspirin on reducing the rate of this complication in patients classified as high risk by this algorithm. A retrospective cohort including 1132 patients attending prenatal care at Clínica Dávila in Santiago, Chile, was conceived. The risk of developing preeclampsia (early and late onset) was calculated using algorithms previously described by Plasencia et al. Patients classified as high risk, in the first trimester of pregnancy, by these algorithms, were candidates to receive 100 mg/daily aspirin as prophylaxis at the discretion of the attending physician. The overall incidence of preeclampsia in this cohort was 3.5% (40/1132), and the model for early onset preeclampsia prediction detected 33% of patients with early onset preeclampsia. Among the 105 patients considered at high risk of developing preeclampsia, 56 received aspirin and 49 patients did not. Among those who received aspirin, 12% (7/56) developed preeclampsia, which is equal to the rate of preeclampsia (12% (6/49)) of those who did not receive this medication. Therefore, the diagnostic performance of an algorithm combining uterine artery Doppler and maternal factors in the first trimester predicted only one third of patients that developed preeclampsia. Among those considered at high risk for developing the disease using this algorithm, aspirin did not change the incidence of preeclampsia, however, this could be due either to the small study sample size or the type of the study, a retrospective, non-interventional cohort study. |
| first_indexed | 2024-04-11T12:51:18Z |
| format | Article |
| id | doaj.art-f92bb3870bae40cf9a447be4ec9f7c8d |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-11T12:51:18Z |
| publishDate | 2020-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-f92bb3870bae40cf9a447be4ec9f7c8d2022-12-22T04:23:13ZengMDPI AGDiagnostics2075-44182020-03-0110418210.3390/diagnostics10040182diagnostics10040182Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical UseMax Mönckeberg0Valentina Arias1Rosario Fuenzalida2Santiago Álvarez3Victoria Toro4Andrés Calvo5Juan P. Kusanovic6Lara J. Monteiro7Manuel Schepeler8Jyh K. Nien9Jaime Martinez10Sebastián E. Illanes11Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad de Los Andes, Santiago 7620001, ChileFaculty of Medicine, Universidad de Los Andes, Santiago 7620001, ChileFaculty of Medicine, Universidad de Los Andes, Santiago 7620001, ChileFaculty of Medicine, Universidad de Los Andes, Santiago 7620001, ChileFaculty of Medicine, Universidad de Los Andes, Santiago 7620001, ChileFaculty of Medicine, Universidad de Los Andes, Santiago 7620001, ChileCenter for Research and Innovation in Maternal-Fetal Medicine (CIMAF), Hospital Sótero del Río, Santiago 8207257, ChileCentre for Biomedical Research, Laboratory of Reproductive Biology, Faculty of Medicine, Universidad de Los Andes, Santiago 7620001, ChileDepartment of Obstetrics and Gynecology, Faculty of Medicine, Universidad de Los Andes, Santiago 7620001, ChileDepartment of Obstetrics and Gynecology, Faculty of Medicine, Universidad de Los Andes, Santiago 7620001, ChileDepartment of Obstetrics and Gynecology, Clínica Dávila, Santiago 8420384, ChileDepartment of Obstetrics and Gynecology, Faculty of Medicine, Universidad de Los Andes, Santiago 7620001, ChilePreeclampsia is a pregnancy-specific disorder defined by new onset of hypertension and proteinuria after 20 weeks of gestation. The early detection of patients at risk of developing preeclampsia is crucial, however, predictive models are still controversial. We aim to evaluate the diagnostic performance of a predictive algorithm in the first trimester of pregnancy, in order to identify patients that will subsequently develop preeclampsia, and to study the effect of aspirin on reducing the rate of this complication in patients classified as high risk by this algorithm. A retrospective cohort including 1132 patients attending prenatal care at Clínica Dávila in Santiago, Chile, was conceived. The risk of developing preeclampsia (early and late onset) was calculated using algorithms previously described by Plasencia et al. Patients classified as high risk, in the first trimester of pregnancy, by these algorithms, were candidates to receive 100 mg/daily aspirin as prophylaxis at the discretion of the attending physician. The overall incidence of preeclampsia in this cohort was 3.5% (40/1132), and the model for early onset preeclampsia prediction detected 33% of patients with early onset preeclampsia. Among the 105 patients considered at high risk of developing preeclampsia, 56 received aspirin and 49 patients did not. Among those who received aspirin, 12% (7/56) developed preeclampsia, which is equal to the rate of preeclampsia (12% (6/49)) of those who did not receive this medication. Therefore, the diagnostic performance of an algorithm combining uterine artery Doppler and maternal factors in the first trimester predicted only one third of patients that developed preeclampsia. Among those considered at high risk for developing the disease using this algorithm, aspirin did not change the incidence of preeclampsia, however, this could be due either to the small study sample size or the type of the study, a retrospective, non-interventional cohort study.https://www.mdpi.com/2075-4418/10/4/182preeclampsiauterine artery dopplerultrasoundgestational hypertensionearly predictionaspirinpredictive algorithmroutine careprenatal care |
| spellingShingle | Max Mönckeberg Valentina Arias Rosario Fuenzalida Santiago Álvarez Victoria Toro Andrés Calvo Juan P. Kusanovic Lara J. Monteiro Manuel Schepeler Jyh K. Nien Jaime Martinez Sebastián E. Illanes Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use Diagnostics preeclampsia uterine artery doppler ultrasound gestational hypertension early prediction aspirin predictive algorithm routine care prenatal care |
| title | Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use |
| title_full | Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use |
| title_fullStr | Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use |
| title_full_unstemmed | Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use |
| title_short | Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use |
| title_sort | diagnostic performance of first trimester screening of preeclampsia based on uterine artery pulsatility index and maternal risk factors in routine clinical use |
| topic | preeclampsia uterine artery doppler ultrasound gestational hypertension early prediction aspirin predictive algorithm routine care prenatal care |
| url | https://www.mdpi.com/2075-4418/10/4/182 |
| work_keys_str_mv | AT maxmonckeberg diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT valentinaarias diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT rosariofuenzalida diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT santiagoalvarez diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT victoriatoro diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT andrescalvo diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT juanpkusanovic diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT larajmonteiro diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT manuelschepeler diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT jyhknien diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT jaimemartinez diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse AT sebastianeillanes diagnosticperformanceoffirsttrimesterscreeningofpreeclampsiabasedonuterinearterypulsatilityindexandmaternalriskfactorsinroutineclinicaluse |