Review article
Using ultrasound and Doppler ultrasound to assess vascular changes in pre-eclampsia and eclampsia: a systematic review
Uso de ultrassom Doppler e ultrassom na avaliação das alterações vasculares na pré-eclampsia e eclampsia: Uma revisão sistemática
Glaucimeire Marquez Francoa,b,
, Marianne de Oliveira Falcoc,d, Waldemar Naves do Amarale,f
Corresponding author
a Department of Obstetrics and Gynecology, Faculty of Medicine, Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brazil
b Hospital Materno Infantil, Goiânia, GO, Brazil
c Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
d Faculty of Nutritionist, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
e Department of Obstetrics and Gynecology, Faculty of Medicine, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
f Laboratory of In Vitro Fertilization and Embryo Cryopreservation Fertility Clinic, Goiânia, GO, Brazil
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"titulo" => "Using ultrasound and Doppler ultrasound to assess vascular changes in pre-eclampsia and eclampsia: a systematic review" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "33" "paginaFinal" => "41" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Glaucimeire Marquez Franco, Marianne de Oliveira Falco, Waldemar Naves do Amaral" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Glaucimeire Marquez" "apellidos" => "Franco" "email" => array:1 [ 0 => "glaucimeiremf@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Marianne" "apellidos" => "de Oliveira Falco" "referencia" => array:2 [ 0 => array:2 [ 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] 3 => array:3 [ "entidad" => "Faculty of Nutritionist, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Department of Obstetrics and Gynecology, Faculty of Medicine, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Laboratory of In Vitro Fertilization and Embryo Cryopreservation Fertility Clinic, Goiânia, GO, Brazil" "etiqueta" => "f" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Uso de ultrassom Doppler e ultrassom na avaliação das alterações vasculares na pré-eclampsia e eclampsia: Uma revisão sistemática" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2542 "Ancho" => 2107 "Tamanyo" => 247634 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow diagram of identification and selection of studies included in the systematic review.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Pre-eclampsia (PE) has been a major cause of maternal and perinatal morbidity and mortality worldwide.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">1</span></a> Although the condition can be treated, PE can be fatal. Ten percent of women experience high blood pressure during pregnancy, and PE cause complications in 2–8% of pregnancies. In general, 10–15% of direct maternal deaths are associated with PE and eclampsia.<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">More than half a million women worldwide die each year from pregnancy-related causes. PE is common and is a major cause of maternal death both in developed and developing countries.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">4</span></a> However, in developing countries, mortality from PE can reach 99%, as it does in some countries in Africa. PE also causes high rates of perinatal and neonatal death. Two Millennium Development Goals—4 and 5—specifically aim to reduce child and maternal mortality.<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">PE affects 2–8% of all pregnancies, although treatment is generally effective. However, 10–15% of direct maternal deaths are associated with PE and eclampsia.<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">2,3</span></a> PE causes complications in the liver, kidneys, brain and the circulatory system. For the newborn, the risks include intrauterine growth retardation (IUGR) and prematurity.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">PE has been called the “disease of theories” because of its enigmatic pathophysiology. Screening for PE and restricted intra uterine growth (IUGR) has been a major clinical and research issue since the disease was first reported in the 19th century.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">1</span></a> Since then, clinical studies have shown that early detection and treatment of PE and eclampsia reduce maternal and fetal morbidity and mortality.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">1,4</span></a> However, preventing PE and eclampsia remain major problems in maternal and child health.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Ultrasound of the brachial artery, and Doppler ultrasound of the ophthalmic artery and uterine artery are propaedeutic, non-invasive methods that contribute to the understanding of the pathophysiology of PE and eclampsia.<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">6–9</span></a>The present study is a systematic review of the literature that evaluates the effectiveness of these tests in assessing vascular function in normal pregnant women and in women with PE and eclampsia to establish the most appropriate methods for the evaluating these diseases.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">For this systematic review, a search protocol not registered in databases of systematic reviews was prepared. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were used.<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">10</span></a> In this protocol all of the following were predefined and limited: the topic of interest, inclusion criteria, search strategies and selection of studies, the quality evaluation form used to record the data for analysis and to present results, and interpretation of study results.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Inclusion criteria varied in accordance with the artery being studied. Articles about Doppler ultrasound of the ophthalmic artery published between 1989 and 2014 were retrieved. All articles published between 2000 and 2014 about using ultrasound to assess flow-mediated dilation of the brachial artery were retrieved. For Doppler ultrasound of the uterine artery, only articles published between January 2013 and March 2014 were retrieved because the literature in this area is extensive. Articles in English and Portuguese were included. Observational and experimental studies conducted in pregnant women without disease or other complications with PE and eclampsia were included if the ophthalmic artery and uterine artery had been assessed by Doppler ultrasound, and flow-mediated dilation of the brachial artery flow had been assessed by ultrasound. Articles that did not fully meet the criteria were excluded.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Two researchers independently conducted an active search for articles. When there was doubt or disagreement among the researchers, a third researcher acted as a mediator.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The databases of the National Library of Medicine (PubMed) and the Virtual Health Library were searched. The following descriptors for the ophthalmic artery were used: <span class="elsevierStyleItalic">ophthalmic artery AND Doppler OR Doppler color ultrasonography OR Doppler sonography AND pregnancy AND preeclampsia/eclampsia OR pre-eclampsia OR toxemia of pregnancy</span>. For the brachial artery, the descriptors used were: <span class="elsevierStyleItalic">brachial artery AND pregnancy AND flow-mediated dilation</span>. For the uterine artery, the descriptors used were: <span class="elsevierStyleItalic">Doppler OR Doppler color ultrasonography OR Doppler sonography AND uterine artery AND pregnancy OR preeclampsia/eclampsia OR pre-eclampsia OR toxemia of pregnancy</span>.</p><p id="par0050" class="elsevierStylePara elsevierViewall">To increase the specificity of the searches, the filters <span class="elsevierStyleItalic">humans and adults</span> were used.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> and <a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1–3</a> show the results. A total of 260 articles were retrieved, of which 32 were eligible for inclusion in the review. There were 16 articles on using Doppler ultrasound to evaluate the ophthalmic artery and eight about using it to assess the uterine artery, and eight articles evaluated using ultrasound to assess flow-mediated dilation of the brachial artery (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the studies included in the review of the ophthalmic artery. Patients with PE showed a decreased pulsatility index and resistance index with vasodilation and cerebral blood flow.<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">6,9,11,12</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> summarizes the studies of using ultrasound to evaluate the brachial artery. Flow-mediated dilation of the brachial artery was lower in pregnant women with pre-eclampsia.</p><p id="par0070" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> summarizes the studies using Doppler ultrasound to assess the uterine artery. All of these studies were cross-sectional. The pulsatility index for this artery was increased in women with PE and eclampsia. Some studies evaluated the correlation between findings on Doppler ultrasound and maternal outcome (PE) and the association with biochemical markers and maternal factors. Other studies were conducted in pregnant women during the first trimester, with the intent of detecting changes before the symptoms of PE were apparent. Another group of studies was performed during the second trimester of pregnancy; a period during which there may already be signs of PE.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Ophthalmic artery</span><p id="par0075" class="elsevierStylePara elsevierViewall">Patients with PE showed a decreased pulsatility index and decreased resistance index, with cerebral vasodilation and increased blood flow.<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">6,9,11,12</span></a> Such changes were present even in patients with PE and photophobia (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a> Nakatsuka et al.<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">14</span></a> observed the same decreases in the pulsatility index and resistance index in pregnant women and in those who used vasodilator drugs (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Barbosa et al.<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">17</span></a> demonstrated that immediately prior to eclampsia the resistance index proved to be an important biomarker at the cut-off of 0.56 (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><p id="par0080" class="elsevierStylePara elsevierViewall">During the second trimester, the combined Doppler assessment of the uterine artery, the ophthalmic artery and ultrasound assessment of flow-mediated dilation of the brachial artery helped differentiate the degree and severity of PE (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">8</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Brandão, Cabral and Leite<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">7,18</span></a> observed that impairment in the placentation process and endothelial dysfunction preceded PE, and that disruption to the blood flow in the central nervous system occurred after the onset of illness (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><p id="par0090" class="elsevierStylePara elsevierViewall">The variables used by Matias et al.<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">38</span></a> to assess the ophthalmic artery using Doppler ultrasound were accurate in the differential diagnosis of hypertensive disorders as well as in assessing the severity and progression of disease (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><p id="par0095" class="elsevierStylePara elsevierViewall">Gurgel et al.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">21</span></a> tested during the first trimester the efficacy of using the pulsatility index of the uterine artery and the first diastolic peak of the ophthalmic artery to detect PE. They observed that the combination of the factors with maternal uterine artery Doppler or ophthalmic arteries can predict 78% of cases of early-onset PE, a TFP of 10%. Maternal changes preceding PE are not limited to the uteroplacental vascular bed (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">18</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Brachial artery</span><p id="par0100" class="elsevierStylePara elsevierViewall">Flow-mediated dilation of the brachial artery is higher in pregnant women without complications than in non-pregnant women, and it has a positive correlation with gestational age up to 32 weeks of gestation (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">22</span></a> Savidou et al.<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">23</span></a> observed that in some pregnant women who develop PE, maternal serum placental growth factor (PlGF) and soluble endoglin (sEng) are altered. However, these changes do not correlate directly with maternal endothelial dysfunction (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><p id="par0105" class="elsevierStylePara elsevierViewall">Brodszki et al.<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">24</span></a> concluded that healthy normotensive pregnant women with bilateral uterine artery resistance showed impaired endothelial function, but no difference was found in vascular mechanical properties (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Chambers et al.<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">25</span></a> found that vascular function was also impaired in non-pregnant women who had PE or hypertension during a previous pregnancy.</p><p id="par0110" class="elsevierStylePara elsevierViewall">Kamat et al.<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">27</span></a> reported that in patients at risk of developing PE, flow-mediated dilation is smaller, and that women with flow-mediated dilation greater than 30% have zero risk of developing PE. This measurement should be performed between 18 and 24 weeks of pregnancy, and can be considered a sensitive early predictor for evaluating patients at risk for PE (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><p id="par0115" class="elsevierStylePara elsevierViewall">Filho et al.<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">28</span></a> reported that their findings suggested that superimposed PE was associated with poorer endothelial function (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><p id="par0120" class="elsevierStylePara elsevierViewall">Flow-mediated dilation less than 4.5% may be used to estimate the risk of PE. Its decrease is directly related to morbidity in PE (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Uterine artery</span><p id="par0125" class="elsevierStylePara elsevierViewall">According to Jamal et al.,<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">30</span></a> Doppler ultrasound used to assess the uterine artery during the second trimester is a useful screening method for identifying a high-risk pregnancy. The authors attributed this to the severity of the disease, as indicated in other theories (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). Lai et al.<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">31</span></a> used this test for patients with a prior maternal history of PE together with blood pressure measurements, and found that there was an improvement in the sensitivity of the assessment (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). Gallo et al.<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">32</span></a> found that in normal pregnancy associated with PE, maternal characteristics and the pulsatility index are associated with the severity of disease (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><p id="par0130" class="elsevierStylePara elsevierViewall">An abnormal average pulsatility index and an abnormal ratio of soluble fms-like tyrosine kinase to placental growth factor are common in early PE (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">33</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Scazzocchio et al.<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">34</span></a> observed that during the first trimester a combined test assessing maternal factors, Doppler ultrasound of the uterine artery, mean arterial pressure and plasma protein A is useful for predicting PE in low-risk pregnancies (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).</p><p id="par0140" class="elsevierStylePara elsevierViewall">In the first trimester, the combination of maternal characteristics and uterine artery Doppler and placental growth factor, can predict about half of pregnancies complicated by early PE (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">36</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">However, during the second trimester, uterine artery Doppler ultrasound in low-risk pregnant women does not effectively identify women who are at risk of complications (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">35</span></a> Nonetheless, it is a useful screening method for identifying high-risk pregnancies. Moreover, the usefulness of Doppler ultrasound of the uterine artery improves when it is combined with a previous maternal history of PE and measurement of mean arterial blood pressure (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">37</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Ultrasound of the uterine artery, used with assessments of orbital circulation and flow-mediated dilation of the brachial artery, help differentiate the degree and severity of PE (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">8</span></a></p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusion</span><p id="par0155" class="elsevierStylePara elsevierViewall">During the first trimester of pregnancy, when tests that assess maternal vascular function are used with knowledge of maternal history, patients who are at risk can be evaluated more effectively. During the second trimester of pregnancy in patients with already established disease, changes are seen on Doppler ultrasound of the uterine artery and ultrasound of flow-mediated dilation, since changes in the ophthalmic artery are seen by Doppler ultrasound after the onset of symptoms of PE.</p><p id="par0160" class="elsevierStylePara elsevierViewall">Based on the findings of this systematic review, Doppler ultrasound of the ophthalmic artery and uterine artery, and ultrasound assessment of flow-mediated dilation of the brachial artery, can be useful in identifying patients at risk and monitoring disease progression, as well as for providing effective treatment.</p><p id="par0165" class="elsevierStylePara elsevierViewall">Our findings show that these methods are useful, making early intervention feasible and thereby improving prognosis and reducing morbidity and mortality of pregnant women and their newborns faced with cases of PE and eclampsia.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicts of interest</span><p id="par0170" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres541605" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec561114" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres541604" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec561115" "titulo" => "Palavras chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:3 [ "identificador" => "sec0020" "titulo" => "Discussion" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Ophthalmic artery" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Brachial artery" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Uterine artery" ] ] ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-03-28" "fechaAceptado" => "2015-03-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec561114" "palabras" => array:6 [ 0 => "Ophthalmic artery" 1 => "Flow-mediated dilation" 2 => "Uterine artery" 3 => "Doppler sonography" 4 => "Pre-eclampsia" 5 => "Eclampsia" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras chave" "identificador" => "xpalclavsec561115" "palabras" => array:6 [ 0 => "Artéria oftálmica" 1 => "Dilatação fluxo-mediada" 2 => "Artéria uterina" 3 => "Sonografia Doppler" 4 => "Pré-eclampsia" 5 => "Eclampsia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This systematic review aimed to evaluate whether Doppler ultrasound of the ophthalmic artery and uterine artery, and ultrasound of flow-mediated dilation of the brachial artery, can be used to effectively assess vascular function in pregnant women without disease or other complications with pre-eclampsia and eclampsia to establish the most appropriate method for evaluating these diseases.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Two databases were searched for relevant articles: the National Library of Medicine (PubMed) and the Virtual Health Library. Articles published between 1989 and 2014 about Doppler ultrasound of the ophthalmic artery were retrieved; all articles published from 2000 to 2014 about using ultrasound to assess flow-mediated dilation of the brachial artery were retrieved; and for Doppler ultrasound of the uterine artery, only articles published between January 2013 and March 2014 were retrieved because the literature in this area is extensive.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 260 articles were retrieved; 32 were eligible for inclusion. There were 16 articles on using Doppler ultrasound to evaluate the ophthalmic artery and eight about using it to assess the uterine artery, and eight articles evaluated the use of ultrasound to assess flow-mediated dilation of the brachial artery.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Doppler ultrasound is useful in diagnosing pre-eclampsia and eclampsia in pregnant women; the use of this technique makes early intervention feasible, and thereby improves prognosis; and it reduces the morbidity and mortality of pregnant women and their newborns.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Essa revisão sistemática teve como objetivo avaliar se o ultrassom Doppler das artérias oftálmica e uterina e o ultrassom de dilatação fluxo-mediada da artéria braquial podem ser utilizados para uma avaliação efetiva da função vascular em mulheres grávidas com pré-eclampsia e eclampsia e sem outras doenças ou complicações, para estabelecer o método mais apropriado para avaliação dessas doenças.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Pesquisa em dois bancos de dados–National Library of Medicine (PubMed) e Virtual Health Library–em busca de artigos relevantes. Foram recuperados artigos publicados entre 1989 e 2014 sobre ultrassom Doppler da artéria oftálmica; todos os artigos publicados de 2000 até 2014 sobre o uso do ultrassom para a avaliação da dilatação fluxo-mediada da artéria braquial; e apenas artigos publicados entre janeiro de 2013 e março de 2014 sobre ultrassom Doppler da artéria uterina, diante da grande riqueza da literatura nessa área.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">No total, foram recuperados 260 artigos; 32 se qualificaram para inclusão: 16 artigos sobre uso do ultrassom Doppler para avaliar a artéria oftálmica, oito artigos sobre o uso dessa técnica para avaliar a artéria uterina e, finalmente, oito artigos sobre o uso do ultrassom para avaliar a dilatação fluxo-mediada da artéria braquial.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusões</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">O ultrassom Doppler tem utilidade no diagnóstico da pré-eclâmpsia e da eclampsia em mulheres grávidas; o uso dessa técnica possibilita uma intervenção precoce e, com isso, melhora o prognóstico; e ainda diminui a morbidade e a mortalidade de grávidas e de seus neonatos.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2542 "Ancho" => 2107 "Tamanyo" => 247634 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow diagram of identification and selection of studies included in the systematic review.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">RI, resistance index; RIOA, resistance index of the ophthalmic artery; PI, pulsatility index; PIOA, pulsatility index of the ophthalmic artery; PIUA, pulsatility index of the uterine artery; PE, pre-eclampsia; MP, mild pre-eclampsia; SP, severe pre-eclampsia; PROA, peak ratio of the ophthalmic artery.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Author/year \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Study design \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Sample \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Degree of evidence \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Results \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Belfort et al.<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">11</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Case–control \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 PE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>↓PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>↓ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Magnesium sulfate produces vasodilation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hata et al.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">12</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 N7 PL3 PG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.75<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.66PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.58<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.66PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.86–2.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PI lowest value in mild pre-eclampsia \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hata et al.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">9</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 PEL6 PEG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.47<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.30PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.17<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PI lowest value in severe pre-eclampsia \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ohno et al.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 with ophthalmological manifestations11 sem ophthalmologic manifestations \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.71<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.17PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.97<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PI lower in patients with ophthalmologic manifestations \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Nakatsuka et al.<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">14</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Case–control \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 PEG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.67<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.47RIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.74<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.6PROA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.83<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vasodilator effect of NO \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ohno et al.<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">15</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Case–control \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 PE puerperal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Prostaglandin E1 vasodilator effect \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Takata et al.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">8</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25 PEL27 PEG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.66<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.25PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.61<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ayaz et al.<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">16</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27 PEL/M3 SP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.91<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.10PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.49PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.52PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PI increased in severe PE \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Diniz et al.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">6</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 MP20 SP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.16<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.25PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.00<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PI severe decreases in PE \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Barbosa et al.<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">17</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">112 imminent eclampsia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RIOA<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RI is a relevant biomarker in imminent eclampsia \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Brandão et al.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">7</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">59 PN15 PE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.70<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.03PIUA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.84<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.12DILA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8.42<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.15RIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.68<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.03PIUA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.20<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.16DILA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.60<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RI did not change in this gestational period \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Brandão et al.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">18</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25 PN26 PE early30 PE late \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.74<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.03DILA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14.12<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.14RIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.63<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.02DILA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>7.62<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.42IRAO<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.65<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.02DILA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>5.83<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Endothelial dysfunction and hyperperfusionCentral nervous system PE early and late \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Matias et al.<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">19</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">274 pregnant women with risk factors for PE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.17<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.53RIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.81<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.81PROA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.53<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Values greater than the normal patients \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">de Oliveira et al.<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">20</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 MP30 SP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.73<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.06PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.63<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.35PROA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.65<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.10RIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.63<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.09PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.13<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.31PROA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.89<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Central hyperperfusion in SP \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gurgel et al.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">21</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22 PE early9 PE late \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PIUA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.85<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.3PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.6PIUA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.60<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.5PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.92<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Evaluates the maternal circulation before vascular changes settle \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Belfort et al.<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">11</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Case–control \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 PE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>↓PIOA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>↓ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Magnesium sulfate produces vasodilation \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab869806.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Studies assessing use of Doppler ultrasound of ophthalmic artery in normal pregnant women and pregnant women with pre-eclampsia (PE).</p>" ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">FMD, flow-mediated dilation; P, pregnant women; NW, non-pregnant women; NP, normal pregnant women; PE, pre-eclampsia; IUGR, intrauterine growth retardation; SPE, superimposed pre-eclampsia; CPE, complicated pre-eclampsia; PECC, pre-eclampsia with a combination of complications (HELLP: H, emolysis; EL, elevated liver enzymes; LP, low platelets, eclampsia, stillbirth); EPE, early pre-eclampsia; LPE, late pre-eclampsia; HA, gestational hypertension; UA, uterine artery.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col">Author/year \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col">Study design \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col">Sample \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col">Degree of evidence \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">FMD</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">NP \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">NW \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PE \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Results \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Savvidou et al.<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">22</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19NW<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>157 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.84<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.18% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">FMD significant increase until 32 weeks. Then there is a decrease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Savvidou et al.<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">23</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">P<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.8 UA without notches7.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.5 UA with notches \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.2 sem CIUR2.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.3 com CIUR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">FMD decreased is a risk factor rather than a cause \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Brodszki et al.<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">24</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">P<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.7% UA without notches6.3% UA with notches \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">FMD decreased in patients with GN uterine incisions. No mechanical differences \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Chambers et al.<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">25</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NW<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>48PE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>113 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">With PE in a previous pregnancy<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.36<span class="elsevierStyleHsp" style=""></span>mmwithout PE in previous Pregnancies<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.29<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">FMD lower in the group that had PE in a previous pregnancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Henriques et al.<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">26</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PE in women with previous pregnancy have a higher frequency of FMD changed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Kamat et al.<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">27</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NW<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>81 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Cut-off</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8.7%, S<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>88%E<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>93% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Filho et al.<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">28</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14SPE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SPE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>6.0% (1.9–10.3)PE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13.6% (4.4–17.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Was not able to differentiate between PE and PES. However, data suggest that SPE is associated with a worse endothelial function \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Vieira et al.<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>11.8% (5.4–16.6%)CPE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>7.4% (2.2–13.3%)CCPE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.8% (0.0–7.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Decreased FMD can be connected directly to morbidity of PE \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab869807.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Studies using ultrasound to assess flow-mediated dilation of brachial artery in non-pregnant women, normal pregnant women and pregnant women with pre-eclampsia (PE).</p>" ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">N, normal pregnant women; GC, pregnancy complicated by pre-eclampsia; IUGR, premature labor, placenta previa, fetal death; EPE, early pre-eclampsia; LPE, late pre-eclampsia; MCH, maternal medical history; MBP, mean blood pressure.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Author/year \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Sample \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Bilateral notches (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Degree of evidence \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Study design \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Results \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Jamal et al.<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">30</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">435N<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>390GC<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.99 (+0.32)GC<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.27 (+0.55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>18 (4.6%)GC<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>9 (20%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">S</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>33%<span class="elsevierStyleItalic">S</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>66% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lai et al.<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">31</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.294 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.71Percentile90<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.02Percentile95<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Second trimester maternal characteristics of the Doppler<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>UA can effectively identify patients at high risk of developing PE \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gallo et al.<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">32</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50.490 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PE<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>34 sem=0.996 PE<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>34<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>38<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.377PE<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>38<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.509 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PI normal pregnancy is associated with maternal characteristicsIn PE the PI is associated with disease severity \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gomes–Arriagaet al.<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">33</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">92 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PE c/IUGR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.43PE s/IUGR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.89<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">EPE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>PI and sFlt-1/PlGF abnormalLPE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>PI normal in 50% of casesA sFlt-1/PlGF shows high specificity and low sensitivity to confirm PE \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Scazzocchio et al.<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">34</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5759 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.67 (0.53–1.25)EPE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.68 (1.54–1.84)LPE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.23 (1.75–3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">First trimester – PAPP-A/b-HCG/PA/Doppler da UA is useful for predicting risk of PE in low-risk patients \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Arcangelli et al.<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">35</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">382 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PE <span class="elsevierStyleItalic">cut-off</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.79EPE <span class="elsevierStyleItalic">cut-off</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Second trimester – Doppler das UA is not efficient in anticipating risk of PE in patients with low risk \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Parra-Cordeiro et al.<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">36</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5367 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Controls PI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.02 (0.83–1.31)EPE PI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.39 (1.14–1.76)PE PI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.14 (0.97–1.43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Característicasmaternas, associadas a AU da Doppler e PlGF pode prever ½ das gestações que serão complicadas pela PEP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Prajapati et al.<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">37</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">200 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.7PE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Uterine Doppler in the 2nd quarter is a useful screening test associated with HCM and PAM greatly enhances the power of the test. \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab869808.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 43 | 7 | 50 |
| 2024 September | 70 | 8 | 78 |
| 2024 August | 81 | 9 | 90 |
| 2024 July | 63 | 6 | 69 |
| 2024 June | 51 | 6 | 57 |
| 2024 May | 98 | 6 | 104 |
| 2024 April | 68 | 6 | 74 |
| 2024 March | 90 | 6 | 96 |
| 2024 February | 103 | 17 | 120 |
| 2024 January | 97 | 10 | 107 |
| 2023 December | 92 | 7 | 99 |
| 2023 November | 92 | 13 | 105 |
| 2023 October | 81 | 9 | 90 |
| 2023 September | 93 | 10 | 103 |
| 2023 August | 57 | 4 | 61 |
| 2023 July | 84 | 8 | 92 |
| 2023 June | 53 | 9 | 62 |
| 2023 May | 108 | 10 | 118 |
| 2023 April | 51 | 4 | 55 |
| 2023 March | 72 | 13 | 85 |
| 2023 February | 57 | 5 | 62 |
| 2023 January | 59 | 9 | 68 |
| 2022 December | 60 | 7 | 67 |
| 2022 November | 66 | 15 | 81 |
| 2022 October | 40 | 10 | 50 |
| 2022 September | 49 | 12 | 61 |
| 2022 August | 71 | 25 | 96 |
| 2022 July | 42 | 13 | 55 |
| 2022 June | 37 | 11 | 48 |
| 2022 May | 30 | 15 | 45 |
| 2022 April | 19 | 14 | 33 |
| 2022 March | 53 | 20 | 73 |
| 2022 February | 57 | 16 | 73 |
| 2022 January | 69 | 22 | 91 |
| 2021 December | 49 | 14 | 63 |
| 2021 November | 77 | 15 | 92 |
| 2021 October | 55 | 11 | 66 |
| 2021 September | 49 | 9 | 58 |
| 2021 August | 28 | 7 | 35 |
| 2021 July | 28 | 15 | 43 |
| 2021 June | 20 | 9 | 29 |
| 2021 May | 54 | 9 | 63 |
| 2021 April | 121 | 16 | 137 |
| 2021 March | 61 | 10 | 71 |
| 2021 February | 49 | 12 | 61 |
| 2021 January | 69 | 13 | 82 |
| 2020 December | 40 | 15 | 55 |
| 2020 November | 73 | 11 | 84 |
| 2020 October | 36 | 6 | 42 |
| 2020 September | 20 | 14 | 34 |
| 2020 August | 27 | 8 | 35 |
| 2020 July | 11 | 4 | 15 |
| 2020 June | 14 | 9 | 23 |
| 2020 May | 25 | 8 | 33 |
| 2020 April | 10 | 5 | 15 |
| 2020 March | 19 | 4 | 23 |
| 2020 February | 16 | 5 | 21 |
| 2020 January | 23 | 5 | 28 |
| 2019 December | 21 | 4 | 25 |
| 2019 November | 33 | 9 | 42 |
| 2019 October | 30 | 6 | 36 |
| 2019 September | 15 | 4 | 19 |
| 2019 August | 5 | 1 | 6 |
| 2019 July | 10 | 5 | 15 |
| 2019 June | 5 | 11 | 16 |
| 2019 May | 81 | 16 | 97 |
| 2019 April | 112 | 12 | 124 |
| 2019 March | 117 | 16 | 133 |
| 2019 February | 105 | 5 | 110 |
| 2019 January | 103 | 5 | 108 |
| 2018 December | 125 | 13 | 138 |
| 2018 November | 156 | 4 | 160 |
| 2018 October | 172 | 2 | 174 |
| 2018 September | 50 | 5 | 55 |
| 2018 August | 17 | 3 | 20 |
| 2018 July | 16 | 10 | 26 |
| 2018 June | 17 | 2 | 19 |
| 2018 May | 14 | 3 | 17 |
| 2018 April | 19 | 6 | 25 |
| 2018 March | 24 | 9 | 33 |
| 2018 February | 21 | 3 | 24 |
| 2018 January | 16 | 7 | 23 |
| 2017 December | 20 | 4 | 24 |
| 2017 November | 15 | 4 | 19 |
| 2017 October | 10 | 5 | 15 |
| 2017 September | 20 | 7 | 27 |
| 2017 August | 24 | 10 | 34 |
| 2017 July | 26 | 2 | 28 |
| 2017 June | 19 | 17 | 36 |
| 2017 May | 30 | 5 | 35 |
| 2017 April | 24 | 1 | 25 |
| 2017 March | 29 | 13 | 42 |
| 2017 February | 97 | 10 | 107 |
| 2017 January | 24 | 4 | 28 |
| 2016 December | 35 | 10 | 45 |
| 2016 November | 35 | 5 | 40 |
| 2016 October | 61 | 14 | 75 |
| 2016 September | 97 | 10 | 107 |
| 2016 August | 0 | 8 | 8 |
| 2016 July | 0 | 10 | 10 |
| 2015 December | 2 | 0 | 2 |
| 2015 November | 2 | 21 | 23 |
| 2015 October | 10 | 28 | 38 |
| 2015 August | 1 | 22 | 23 |
Show all