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Uterine arteries pulsatility index by Doppler ultrasound in the prediction of preeclampsia: an updated systematic review and meta-analysis

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Abstract

Background

Preeclampsia is a common pregnancy complication with serious potential risks for maternal and neonatal health. Early prediction of preeclampsia is crucial for timely prevention, surveillance, and treatment to improve maternal and neonatal outcomes. This systematic review aimed to summarize the available evidence on the prediction of preeclampsia based on Doppler ultrasound of uterine arteries at different gestational ages.

Methods

A systematic literature search and meta-analysis were conducted to evaluate the sensitivity and specificity of the pulsatility index of Doppler ultrasound of uterine arteries for predicting preeclampsia. The timing of ultrasound scans within and beyond 20 weeks of gestational age was compared to assess its effect on the sensitivity and specificity of the pulsatility index.

Results

This meta-analysis included 27 studies and 81,673 subjects (3309 preeclampsia patients and 78,364 controls). The pulsatility index had moderate sensitivity (0.586) and high specificity for predicting preeclampsia (0.879) (summary point: sensitivity 0.59; 1-specificity 0.12). Subgroup analysis revealed that ultrasound scans performed within 20 weeks of gestational age did not significantly affect the sensitivity and specificity for predicting preeclampsia. The summary receiver operator characteristic curve showed the pulsatility index’s optimal range of sensitivity and specificity.

Conclusions

The uterine arteries pulsatility index measured by Doppler ultrasound is useful and effective for predicting preeclampsia and should be implemented in the clinical practice. The timing of ultrasound scans at different gestational age ranges does not significantly affect the sensitivity and specificity.

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Data availability

Data available under the reasonable request to the corresponding author.

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Author notes

  1. Yan Liu and Zilu Xie are co-first authors and contributed equally to this work.

Authors and Affiliations

  1. B Ultrasonic room, The First People’s Hospital of Lianyungang, Lianyungang City, 222006, Jiangsu Province, China

    Yan Liu

  2. Department of Ultrasound Medicine, Jing men no. 2 People’s Hospital, Jingmen City, 448000, Hubei Province, China

    Zilu Xie

  3. Department of Ultrasound Medicine, Jiangjin Central Hospital, Chongqing, 402260, China

    Yong Huang

  4. Department of Ultrasound Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an City, 721000, Shaanxi Province, China

    Xin Lu

  5. Department of Obstetrics and Gynecology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, No. 199 Jiefang South Road, Quanshan District, Xuzhou City, 221000, Jiangsu Province, China

    Fengling Yin

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Contributions

Research idea and study design: LY and XZ; data acquisition: LY and XZ; data analysis/interpretation: LY and XZ; statistical analysis: HY and LX; supervision or mentorship: YF. All authors takes responsibility that this study has been reported honestly, accurately and transparently, and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.

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Correspondence to Fengling Yin.

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Liu, Y., Xie, Z., Huang, Y. et al. Uterine arteries pulsatility index by Doppler ultrasound in the prediction of preeclampsia: an updated systematic review and meta-analysis. Arch Gynecol Obstet 309, 427–437 (2024). https://doi.org/10.1007/s00404-023-07044-2

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