Maternal Ophthalmic Artery Doppler Effective option for detecting Pre-Eclampsia

Pre-eclampsia, a potentially dangerous condition characterized by high blood pressure during pregnancy, affects millions of women worldwide. Early detection of pre-eclampsia is crucial for timely interventions and better management of the condition. In a recent prospective cohort study published in Journal Of Obstetrics And Gynaecology Of India, researchers led by Pooja Shah aimed to assess the predictive accuracy of various maternal characteristics and diagnostic measures in identifying the subsequent development of pre-eclampsia during the second trimester of pregnancy.

The study involved 440 pregnant women at 19 to 24 weeks' gestation. Researchers recorded maternal demographic characteristics and calculated the Hypertensive Disorder of Pregnancy (HDP) Gestosis Score. They also measured the Mean Arterial Pressure (MAP) and performed ultrasound evaluations, including Uterine Artery Doppler (UtAPI) and Maternal Ophthalmic Artery Doppler (OAD) assessments. The Mean Peak Systolic Velocity (PSV) ratio was obtained by taking two sets of readings from both eyes.

The findings of the study were:

● Among the 440 pregnant women, 43 (10.8%) developed Hypertensive Disorder of Pregnancy, with 8 having early-onset pre-eclampsia, 16 with late-onset pre-eclampsia, and 19 with gestational hypertension (GHTN). The overall incidence rate of pre-eclampsia was 10.8%.

● Combining the HDP Gestosis Score with OAD PSV Ratio yielded the highest Area Under Curve (AUC) of 0.73, indicating improved predictive accuracy for pre-eclampsia. Moreover, when combining the Gestosis Score with MAP, UtAPI, and OAD-PSV Ratio, the highest sensitivity of 97.67% was achieved.

● The OAD PSV Ratio significantly improved the detection rate of the Gestosis Score for predicting the development of pre-eclampsia, particularly preterm pre-eclampsia, at a 10% False Positive Rate.

The results of this study are promising, suggesting that maternal Ophthalmic Artery Doppler study can significantly enhance the prediction of pre-eclampsia during the second trimester of pregnancy. This diagnostic measure, when used independently or in combination with the HDP Gestosis Score, Mean Arterial Pressure, and Uterine Artery Doppler, showed improved accuracy in identifying women at risk of developing pre-eclampsia. Early identification of pre-eclampsia is vital for better management and improved outcomes for both mother and baby. The findings of this study may pave the way for further research and advancements in prenatal care, leading to more effective strategies for detecting and managing pre-eclampsia.

Reference:

Shah, P., Maitra, N., Vaishnav, P., Dhruv, J., Shyam, T. S., & Pandya, P. (2023). Performance of HDP-gestosis score and ophthalmic artery Doppler in prediction of pre-eclampsia. Journal of Obstetrics and Gynaecology of India. https://doi.org/10.1007/s13224-023-01799-z