First trimester markers of preeclampsia in twins: maternal mean arterial pressure and uterine artery Doppler pulsatility index. (6th June 2014)

• Record Type: Journal Article
• Authors: Svirsky, R.; Yagel, S.; Ben‐Ami, I.; Cuckle, H.; Klug, E.; Maymon, R.
• Is Part Of: Prenatal diagnosis. Volume 34:Number 10(2014:Oct.)
• Page Start: 956
• Page End: 960
• Publication Date: 2014-06-06
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.4402
• Languages: English
• ISSNs: 0197-3851

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="pd4402-sec-0001" sec-type="section"> <title>Objective</title> <p>This study aims to evaluate the distribution of mean arterial pressure (MAP) and uterine artery Doppler pulsatility index (PI) in first trimester twins with and without preeclampsia.</p> </sec> <sec id="pd4402-sec-0002" sec-type="section"> <title>Method</title> <p>A total of 147 twins were recruited from a specialist clinic and 110 unaffected singleton pregnancies attending the same institution served as controls. MAP and Doppler PI values were expressed in multiples of the gestation‐specific median using published equations.</p> </sec> <sec id="pd4402-sec-0003" sec-type="section"> <title>Results</title> <p>Among the twins, 12 had preeclampsia and two had pregnancy‐induced hypertension. Among unaffected pregnancies, there was no significant difference in MAP levels between twins and singletons (<italic>P</italic> = 0.17, Wilcoxon rank sum test, two‐tail). However, the Doppler PI levels were highly statistically significantly lower than in singletons (<italic>P</italic> < 0.0005). MAP was unrelated to chorionicity (<italic>P</italic> = 0.46), but there was a statistically significant increase in Doppler PI among monochorionic compared with dichorionic twins (<italic>P</italic> < 0.01). In twins with preeclampsia, MAP was significantly higher than in unaffected twins (<italic>P</italic> < 0.02, one‐tail), whereas Doppler PI levels were significantly <italic>reduced</italic> (<italic>P</italic> < 0.01, two‐tail).</p> </sec> <sec id="pd4402-sec-0004" sec-type="section"> <title>Conclusion</title> <p>If first trimester screening for preeclampsia is extended to twins, a different normal median Doppler PI equation will be needed. Contrary to expectations, Doppler PI levels may not be raised in affected twins, although this needs confirmation in a larger study. © 2014 John Wiley & Sons, Ltd.</p> </sec> </abstract>