A combined technique for predicting pre-eclampsia: concurrent measurement of uterine perfusion and analysis of heart rate and blood pressure variability

Journal of Hypertension
T WaltherRenaldo Faber

Abstract

Pre-eclampsia is a serious complication of pregnancy with high morbidity and mortality and an incidence of 3-5% in all pregnancies. Early prediction is still insufficient in clinical practice. Although most pre-eclamptic patients have pathological uterine perfusion in the second trimester, perfusion disturbance has a positive predictive accuracy (PPA) only of approximately 30%. Non-invasive continuous blood pressure recordings were taken simultaneously via a finger cuff for 30 min. Time series of systolic as well as diastolic beat-to-beat pressure values were extracted to analyse heart rate and blood pressure variability and baroreflex sensitivity in 102 second-trimester pregnancies, to assess predictability for pre-eclampsia (n = 16). All women underwent Doppler investigations of the uterine arteries. We identified a combination of three variability and baroreflex parameters to best predict pre-eclampsia several weeks before clinical manifestation. The discriminant function of these three parameters classified patients with later pre-eclampsia with a sensitivity of 87.5%, a specificity of 83.7%, and a PPA of 50.0%. Combined with Doppler investigations of uterine arteries, PPA increased to 71.4%. This technique of incorporating...Continue Reading

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Citations

Jul 2, 2008·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Alison K SheaMeir Steiner
Jul 17, 2013·Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences·Gonzalo Marcelo Ramírez ÁvilaNiels Wessel
May 28, 2010·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Virginia L BrooksCheryl M Heesch
Nov 26, 2013·Applied Psychophysiology and Biofeedback·Martin SiepmannKerstin Weidner
Sep 1, 2007·Women's Health·Mike S Rogers
Oct 9, 2009·Clinical and Experimental Hypertension : CHE·G K PalPravati Pal
Jun 4, 2013·Autonomic Neuroscience : Basic & Clinical·G M Ramírez ÁvilaN Wessel
Dec 18, 2013·Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy·Thomas WaltherRenaldo Faber
Nov 28, 2017·Clinical and Experimental Hypertension : CHE·Jing GuoGang Guo
Oct 11, 2017·Anesthesia and Analgesia·Tammy Y EulianoMonique Ho
Nov 12, 2020·Hypertension·Rikki M Tanner, Natalie A Bello

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