The use of Doppler velocimetry of the ophthalmic artery and the fullPIERS model to predict adverse outcomes in hospitalized pregnant women with preeclampsia: a prospective cohort study.

OBJECTIVE

To evaluate the role of Doppler ophthalmic artery (DOA) indices and fullPIERS score in predicting adverse maternal outcomes in pregnant women hospitalized for preeclampsia (PE).

METHODS

Prospective cohort study conducted in pregnant women with PE and signs of deterioration. All pregnant women with PE with signs of clinical deterioration and with target organ involvement were evaluated when hospitalized, between September 2019 and November 2022. DOA indices and fullPIERS score were performed and the main adverse outcomes were analyzed. Main outcome measures: Maternal hypertensive crises, injury of central nervous system, liver, kidney and other outcomes related to PE. Attending clinicians were blinded to the DOA results. We included 138 pregnant women and lost 13 cases prospectively.

MAIN OUTCOME MEASURES

Maternal hypertensive crises, central nervous system injury, liver, kidney and other preeclampsia-related outcomes. Results: The AOD that demonstrated the best predictive effect of composite adverse outcomes in the study population was the second peak systolic velocity (P2), with a moderate effect when adopting a cutoff point of 21.2 cm/s (OR 3.04, 95% CI 1.45-6.33). P2 was able to correctly identify 70% of pregnant women with PE who progressed to composite adverse outcomes, with a false positive rate of 30%. The fullPIERS score was a weak predictor of adverse outcomes in pregnant women with PE.

CONCLUSION

The peak systolic velocity, P2 and EDV obtained from the AOD, as well as the fullPIERS model, were able to predict adverse maternal outcomes in pregnant women hospitalized with PE. A P2 cutoff point ≥21.2 cm/s provided the best prediction for adverse maternal outcomes.