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Open AccessArticle

Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use

1
Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad de Los Andes, Santiago 7620001, Chile
2
Faculty of Medicine, Universidad de Los Andes, Santiago 7620001, Chile
3
Center for Research and Innovation in Maternal-Fetal Medicine (CIMAF), Hospital Sótero del Río, Santiago 8207257, Chile
4
Division of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
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Centre for Biomedical Research, Laboratory of Reproductive Biology, Faculty of Medicine, Universidad de Los Andes, Santiago 7620001, Chile
6
Department of Obstetrics and Gynecology, Clínica Dávila, Santiago 8420384, Chile
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(4), 182; https://doi.org/10.3390/diagnostics10040182
Received: 22 January 2020 / Revised: 26 February 2020 / Accepted: 4 March 2020 / Published: 26 March 2020
(This article belongs to the Section Pathology and Molecular Diagnostics)
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. View Full-Text
Keywords: preeclampsia; uterine artery Doppler; ultrasound; gestational hypertension; early prediction; aspirin; predictive algorithm; routine care; prenatal care preeclampsia; uterine artery Doppler; ultrasound; gestational hypertension; early prediction; aspirin; predictive algorithm; routine care; prenatal care
MDPI and ACS Style

Mönckeberg, M.; Arias, V.; Fuenzalida, R.; Álvarez, S.; Toro, V.; Calvo, A.; Kusanovic, J.P.; Monteiro, L.J.; Schepeler, M.; Nien, J.K.; Martinez, J.; Illanes, S.E. Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use. Diagnostics 2020, 10, 182.

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