Maternal renal and ophthalmic Doppler parameters in prediction of hypertensive disorders of pregnancy

BACKGROUND: Hypertensive disorders of pregnancy are one of the leading causes of maternal and child morbidity and mortality. Detection of patients with high risk of these disorders allows timely prevention of their development. Existing models for risk assessment have an accuracy of up to 80%. Therefore, search for additional markers and risk factors that can be used in risk evaluation is needed. AIM: To evaluate the relationship between maternal first and second trimester renal and ophthalmic Doppler blood flow parameters and the risk of hypertensive disorders pregnancy. METHODS: This was a prospective, observational, single-center study. During the first and second prenatal screening, Doppler parameters in the renal (resistance index) and ophthalmic arteries (resistance index, pulsation index, velocity values and their ratios – PR and DV/P2) were evaluated. We analysed the pregnancy course and outcomes and compared Doppler parameters in patients with uncomplicated pregnancy and with hypertensive disorders. RESULTS: 353 pregnant women were included. 135 patients were examined at 19-21 weeks. Information on pregnancy outcomes was obtained from 324 patients. 32 pregnant women were diagnosed with hypertensive pregnancy disorders. These patients had significantly higher values of body mass index, blood pressure (p0.001), higher average and maximum values of PR (p=0.036 and p=0.036, respectively) and lower - of DV/P2 (p=0.041 and p=0.015, respectively) in the second trimester. Risk of hypertensive pregnancy disorders was 2.4 and 3.4 times higher in patients with PR0.55 in the first trimester and PR0.60 in the second trimester, respectively. The risk of hypertensive complications was 7.3 times higher in patients with the second trimester DV/P2 values 0.90. CONCLUSION: Distinctive features of blood flow in the ophthalmic artery in patients with hypertensive disorders of pregnancy were identified. The discovered patterns are of interest for further study of their role in predicting individual risks of pregnancy complications.