Doppler de arterias uterinas en la semana 20. ¿Cuál es el mejor parámetro para la predicción de preeclampsia?

Article information

Resumen

Objetivo

Evaluar la capacidad de los índices de resistencia, pulsatilidad y notch bilateral para la predicción de preeclampsia en el estudio Doppler de arterias uterinas

Material y métodos

Estudio prospectivo a 319 gestantes en la semana 20. Se midieron manualmente los índices de resistencia y pulsatilidad medios para ambas arterias uterinas y se valoró subjetivamente la presencia de notch bilateral

Resultados

Aplicando los P-75, P-90 y P-95 para los índices de resistencia y de pulsatilidad, se obtienen los mismos resultados para ambos en la predicción de preeclampsia: sensibilidad de 72,7, 54,5 y 45,4%, respectivamente; especificidad de 73,7, 89,9 y 95,4% para índice de resistencia y de 73,05, 91,2 y 96,1% para índice de pulsatilidad. Si se utiliza el notch bilateral, sus resultados son similares a los índices de impedancia al P-95

Conclusiones

Es preciso utilizar un parámetro objetivo de medida, y no existen diferencias entre escoger el índice de resistencia o el de pulsatilidad. Aunque la evaluación del notch bilateral es subjetiva, debe valorarse como variable independiente

Palabras Clave:

Doppler de arterias uterinas

Preeclampsia

Índice resistencia

Índice pulsatilidad

Notch bilateral

Abstract

Objective

To evaluate the capacity of the resistance index, pulsatility index and bilateral notches to predict preeclampsia in uterine artery Doppler study

Material and methods

We performed a prospective study of 319 pregnant women at 20 weeks. The mean resistance and pulsatility indexes for both uterine arteries were measured manually and the presence of bilateral notches was evaluated subjectively

Results

P-75, P-90 and P-95 cut-off levels were applied to the resistance and pulsatility indexes and the same results were obtained for both in the prediction of preeclampsia. Sensitivity was 72.7%, 54.5% and 45.4%, respectively. Specificity was 73.7%, 89.9% and 95.4% for the resistance index and 73.05%, 91.2% and 96.1% for the pulsatility index. For bilateral notches the results were similar to impedance at P-95.

Conclusions

Use of an objective measurement is important; no differences were found between the resistance and pulsatility indexes. Although evaluation of bilateral notches is subjective, it is useful as an independent variable

Key Words:

Uterine artery Doppler

Preeclampsia

Resistance index

Pulsatility index

Bilateral notches

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