VIENNA — Uterine artery velocimetry performed at 24 weeks' gestation is a useful tool for predicting recurrence of preeclampsia and other complications in women who had preeclampsia in a previous pregnancy, Tiziana Frusca, M.D., reported.
A normal uterine artery velocimetry (UAV) at 24 weeks suggests a preeclampsia recurrence risk of less than 1%, whereas an abnormal result suggests a one-in-four chance that the patient will become preeclamptic again, as well as an elevated risk of other complications.
“Knowing these patients are at very high risk, we can monitor them more closely,” Dr. Frusca said during the 14th World Congress of the International Society for the Study of Hypertension in Pregnancy.
Among 206 women with documented preeclampsia in a previous pregnancy, 39% had had severe or early-onset preeclampsia, 21% had chronic maternal disorders such as hypertension or autoimmune disorders, and 77% had been treated prophylactically with low-dose aspirin.
Preeclampsia recurred in 5.3% of subsequent pregnancies, whereas 12% (24) had hypertension without proteinuria, 14% (28) had intrauterine growth retardation (IUGR), and 1% (2) had placental abruption.
Abnormal UAV—defined as a mean resistance index greater than 0.65 and/or the presence of bilateral notches—was identified in a total of 20% (41) of the women, while 80% (165) had normal UAV.
Complications were significantly more common among the women with abnormal UAV and included hypertension without proteinuria (29% vs. 7%), IUGR (44% vs. 6%), and preeclampsia (24% vs. 0.6%), said Dr. Frusca of the department of ob.gyn. at the University of Brescia, Italy.
There were no differences in outcome related to whether the prior preeclampsia had been early vs. late, whether the mother had any underlying chronic conditions, or whether she had been treated previously with low-dose aspirin, according to Dr. Frusca.
These results suggest an overall preeclampsia recurrence risk of 1 in 19, which rises to 1 in 4 if the woman has an abnormal Doppler at 24 weeks. However, if the UAV is normal, the recurrence risk is only 1 in 165.
“A normal uterine artery velocimetry at 24 weeks is a very reassuring sign in a woman with previous preeclampsia,” Dr. Frusca said.