Ophthalmic artery peak systolic velocity ratio distinguishes pre-eclampsia from chronic and gestational hypertension: A prospective cohort study.

Abstract

OBJECTIVE:

To examine whether the ophthalmic artery peak systolic velocity ratio (OA PSV-ratio) is higher in women with pre-eclampsia compared with gestational hypertension (GH) and chronic hypertension (CH), after controlling for confounding variables.

DESIGN:

Prospective cohort.

SETTING:

Specialist hypertension clinic in a tertiary referral centre.

POPULATION:

Singleton pregnancies presenting between 32+0 and 36+6  weeks of gestation with pre-eclampsia (n = 50), GH (n = 54) and CH (n = 56).

METHODS:

Paired measurements of maternal mean arterial pressure (MAP) and OA PSV-ratio were performed by trained sonographers. Multiple linear regression was fitted to the OA PSV-ratio, including maternal characteristics and medical history, GH, pre-eclampsia and MAP and use of antihypertensive medication.

MAIN OUTCOME MEASURE:

Whether pre-eclampsia is independently associated with higher OA PSV-ratio.

RESULTS:

MAP was significantly higher in both GH (p = 0.0015) and pre-eclampsia (p = 0.008) than in CH pregnancies. There was no significant difference between pre-eclampsia and GH (0.670). The OA PSV-ratio was significantly higher in pre-eclampsia than CH (p = 0.0008) and GH (p = 0.015). There was no significant difference between the OA PSV-ratio in CH and GH (p = 0.352). Multiple linear regression modelling showed that the OA PSV-ratio was influenced by maternal weight (p = 0.005), maternal age (p = 0.014), antihypertensive medications (p = 0.007) and MAP (p < 0.0001). After controlling for these variables, the OA PSV-ratio was still significantly higher in those with pre-eclampsia (p = 0.0002).

CONCLUSIONS:

The OA PSV-ratio is influenced by maternal weight, age, antihypertensive medications and MAP. Pre-eclampsia is an independent predictor of OA PSV-ratio, which therefore may be a useful point-of-care test when assessing women presenting with hypertension.

• Authors: Katherine G Y Lau, Allan Wright, Emmanouil Kountouris, Kypros H Nicolaides, Nikos A Kametas
• Journal: BJOG : an international journal of obstetrics and gynaecology (BJOG) Vol. 129 Issue 8 Pg. 1386-1393 (07 2022) ISSN: 1471-0528 [Electronic] England
• PMID: 34913252 (Publication Type: Journal Article)
• Copyright: © 2021 John Wiley & Sons Ltd.

Chemical References

• Antihypertensive Agents

Topics

• Antihypertensive Agents
• Cohort Studies
• Female
• Gestational Age
• Humans
• Hypertension, Pregnancy-Induced (diagnosis)
• Ophthalmic Artery (diagnostic imaging)
• Pre-Eclampsia (diagnosis)
• Pregnancy
• Prospective Studies