Maternal renal and ophthalmic artery doppler parameters in predicting pregnancy-induced hypertension

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Abstract

BACKGROUND: Pregnancy-induced hypertension is one of the leading causes of maternal and perinatal morbidity and mortality. Identifying high-risk patients enables timely prevention of this complication. Existing models can predict individual risk of pregnancy-induced hypertension with up to 80% accuracy, indicating that additional markers and risk factors need to be identified to improve their performance.

AIM: The work aimed to assess the relationship between maternal renal and ophthalmic artery Doppler parameters in the first and second trimesters and the risk of pregnancy-induced hypertension.

METHODS: A prospective, single-center observational study was conducted. During the first and second prenatal screenings, the renal (resistance index) and ophthalmic (resistance index, pulsation index, velocity, peak ratio [PR], and DV/P2) artery Doppler parameters were additionally assessed. The course of pregnancy and its outcomes were then assessed, and the examined blood flow parameters were compared between patients with uncomplicated pregnancy and those with pregnancy-induced hypertension.

RESULTS: The study included 353 pregnant women, with 135 receiving a follow-up examination in the second trimester. Pregnancy outcomes were reported for 324 patients who were initially included in the study. Pregnancy-induced hypertension was reported in 32 patients. These patients had significantly higher body mass index and systolic, diastolic, and mean blood pressure (p < 0.001 for all). Moreover, they had higher average and maximum PR values (p = 0.036 and p = 0.036, respectively) and lower average and maximum DV/P2 values (p = 0.041 and p = 0.015, respectively) at 19–21 weeks of pregnancy. The risk of pregnancy-induced hypertension was 2.4 and 3.4 times higher in patients with PR > 0.55 in the first trimester and PR > 0.60 in the second trimester, respectively. Furthermore, the risk of pregnancy-induced hypertension was 7.3 times higher in patients with DV/P2 < 0.90 in the second trimester.

CONCLUSION: The study identified distinctive characteristics of the ophthalmic artery blood flow in patients with pregnancy-induced hypertension. Further research is needed to assess the role of these patterns in predicting individual risks of pregnancy complications.

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About the authors

Maria M. Bulanova

Lomonosov Moscow State University; City Clinical Hospital No. 67 n.a. L. A. Vorokhobov

Author for correspondence.
Email: mariabulanova98@gmail.com
ORCID iD: 0000-0002-9569-3334
SPIN-code: 6062-0083
Russian Federation, Moscow; Moscow

Valerian V. Shamugiya

City Clinical Hospital No. 67 n.a. L. A. Vorokhobov

Email: ShamugiyaVV@zdrav.mos.ru
ORCID iD: 0009-0008-6757-7660
SPIN-code: 4953-0275

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Maria A. Ponimanskaya

City Clinical Hospital No. 67 n.a. L. A. Vorokhobov

Email: PonimanskayaMA@zdrav.mos.ru
ORCID iD: 0000-0001-9447-110X
SPIN-code: 7113-6744

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Elena Yu. Andreeva

City Clinical Hospital No. 67 n.a. L. A. Vorokhobov

Email: elenaandreeva@list.ru
ORCID iD: 0009-0009-8399-2271
SPIN-code: 2733-1037
Russian Federation, Moscow

Ksenia M. Kaiibkhanova

City Clinical Hospital No. 67 n.a. L. A. Vorokhobov

Email: ksepushek@mail.ru
ORCID iD: 0009-0006-9105-5219
SPIN-code: 2724-6709

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Olga B. Panina

Lomonosov Moscow State University

Email: olgapanina@yandex.ru
ORCID iD: 0000-0003-1397-6208
SPIN-code: 2105-6871

MD, Dr. Sci. (Medicine)

Russian Federation, Moscow

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2. Fig. 1. Assessment of the renal artery blood flow resistance index.

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3. Fig. 2. First systolic peak (P1), second systolic peak (P2), initial diastolic velocity (DV), end-diastolic velocity (EDV), and estimates of the pulsatility index (PI) and resistance index (RI) of blood flow in the ophthalmic artery.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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