Naves Welington Ued, Moreira Renato Augusto, Nascimento Pereira Monteiro Viviane, Peixoto Alberto Borges, Freitas Castro Luis Gustavo, Melo Costa Pinto Rogério de, Diniz Angélica Lemos Debs
Department of Obstetrics and Gynecology, Federal University of Uberlândia-UFU, Uberlândia, Brazil.
National Institute of Women's, Children's and Adolescents Health Fernandes Figueiras, Oswaldo Cruz Fundation, Fluminense Federal University, Niterói, Brazil.
J Matern Fetal Neonatal Med. 2025 Dec;38(1):2526112. doi: 10.1080/14767058.2025.2526112. Epub 2025 Jul 13.
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).
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.
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.
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.
评估多普勒眼动脉（DOA）指数和全PIERS评分在预测因子痫前期（PE）住院的孕妇不良妊娠结局中的作用。
对患有PE且有病情恶化迹象的孕妇进行前瞻性队列研究。2019年9月至2022年11月期间，对所有患有临床病情恶化迹象且有靶器官受累的PE孕妇在住院时进行评估。进行DOA指数和全PIERS评分，并分析主要不良结局。主要结局指标：孕产妇高血压危象、中枢神经系统损伤、肝脏、肾脏及其他与PE相关的结局。主治医生对DOA结果不知情。我们纳入了138名孕妇，前瞻性地失访了13例。
孕产妇高血压危象、中枢神经系统损伤、肝脏、肾脏及其他子痫前期相关结局。结果：在研究人群中，对复合不良结局显示出最佳预测效果的眼动脉舒张末期血流速度（AOD）参数是收缩期第二峰流速（P2），采用21.2 cm/s的截断点时效果中等（比值比[OR] 3.04，95%置信区间[CI] 1.45 - 6.33）。P2能够正确识别70%进展为复合不良结局的PE孕妇，假阳性率为30%。全PIERS评分对PE孕妇不良结局的预测能力较弱。
从AOD获得的收缩期峰值流速、P2和舒张末期血流速度（EDV）以及全PIERS模型能够预测因PE住院的孕妇的不良妊娠结局。P2截断点≥21.2 cm/s对不良妊娠结局的预测效果最佳。
