B Ultrasonic room, The First People's Hospital of Lianyungang, Lianyungang City, 222006, Jiangsu Province, China.
Department of Ultrasound Medicine, Jing men no. 2 People's Hospital, Jingmen City, 448000, Hubei Province, China.
Arch Gynecol Obstet. 2024 Feb;309(2):427-437. doi: 10.1007/s00404-023-07044-2. Epub 2023 May 22.
Preeclampsia is a common pregnancy complication with serious potential risks for maternal and neonatal health. Early prediction of preeclampsia is crucial for timely prevention, surveillance, and treatment to improve maternal and neonatal outcomes. This systematic review aimed to summarize the available evidence on the prediction of preeclampsia based on Doppler ultrasound of uterine arteries at different gestational ages.
A systematic literature search and meta-analysis were conducted to evaluate the sensitivity and specificity of the pulsatility index of Doppler ultrasound of uterine arteries for predicting preeclampsia. The timing of ultrasound scans within and beyond 20 weeks of gestational age was compared to assess its effect on the sensitivity and specificity of the pulsatility index.
This meta-analysis included 27 studies and 81,673 subjects (3309 preeclampsia patients and 78,364 controls). The pulsatility index had moderate sensitivity (0.586) and high specificity for predicting preeclampsia (0.879) (summary point: sensitivity 0.59; 1-specificity 0.12). Subgroup analysis revealed that ultrasound scans performed within 20 weeks of gestational age did not significantly affect the sensitivity and specificity for predicting preeclampsia. The summary receiver operator characteristic curve showed the pulsatility index's optimal range of sensitivity and specificity.
The uterine arteries pulsatility index measured by Doppler ultrasound is useful and effective for predicting preeclampsia and should be implemented in the clinical practice. The timing of ultrasound scans at different gestational age ranges does not significantly affect the sensitivity and specificity.
子痫前期是一种常见的妊娠并发症，对母婴健康有严重的潜在风险。早期预测子痫前期对于及时预防、监测和治疗以改善母婴结局至关重要。本系统评价旨在总结基于不同妊娠龄子宫动脉多普勒超声的子痫前期预测的现有证据。
进行系统文献检索和荟萃分析，以评估子宫动脉多普勒超声搏动指数预测子痫前期的敏感性和特异性。比较了在妊娠 20 周内和 20 周后进行超声扫描的时间，以评估其对搏动指数的敏感性和特异性的影响。
本荟萃分析纳入了 27 项研究和 81673 名受试者（3309 例子痫前期患者和 78364 名对照）。搏动指数对预测子痫前期具有中等敏感性（0.586）和高度特异性（0.879）（汇总点：敏感性 0.59；1-特异性 0.12）。亚组分析显示，在妊娠 20 周内进行的超声扫描并未显著影响预测子痫前期的敏感性和特异性。汇总受试者工作特征曲线显示了搏动指数的最佳敏感性和特异性范围。
多普勒超声测量的子宫动脉搏动指数对于预测子痫前期是有用且有效的，应该在临床实践中实施。不同妊娠龄范围的超声扫描时间并不显著影响敏感性和特异性。
