Details

Autor(en) / Beteiligte

• Pagani, Giorgio
• Reggia, Rossella
• Andreoli, Laura
• Prefumo, Federico
• Zatti, Sonia
• Lojacono, Andrea
• Tincani, Angela
• Frusca, Tiziana

Titel

The role of second trimester uterine artery Doppler in pregnancies with systemic lupus erythematosus

Ist Teil von

• Prenatal diagnosis, 2015-05, Vol.35 (5), p.447-452

Ort / Verlag

England: Blackwell Publishing Ltd

Erscheinungsjahr

2015

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• Objective The aim of this article is to assess the predictive value of second trimester mean uterine artery Doppler pulsatility index (mUtA PI) for pregnancy complications in women with systemic lupus erythematosus (SLE). Methods Cohort study of consecutive pregnancies complicated with SLE during a period of 12 years is used. SLE diagnosis was made before pregnancy. mUtA PI was measured between 23 + 0 and 26 + 6 weeks' gestation. Pregnancy and neonatal outcomes were collected. Small for gestational age (SGA) was defined as birth weight <10th percentile. Adverse pregnancy outcome (APO) was defined as one of the following: pre‐eclampsia (PE), SGA, placental abruption, stillbirth, or neonatal death. Differential diagnosis between PE and renal flare was made according to SLE‐disease activity index. Results There are 70 pregnancies in 64 women. PE was observed in four cases (6%), SGA in five cases (7%), and APO in seven cases (10%). mUtA PI showed a sensitivity and a specificity of 1.0 (95% CI 0.5–1.0) and 1.0 (95% CI 0.95–1.0) for PE, 0.40 (95% CI 0.12–0.77) and 0.97 (95% CI 0.89–0.99) for SGA, and 0.57 (95% CI 0.25–0.84) and 1.0 (95% CI 0.94–1.0) for APO, respectively. Conclusion Our findings suggest that uterine artery Doppler is confirmed to be a high sensitivity and a high specificity test for predicting PE even in SLE patients. © 2014 John Wiley & Sons, Ltd. What's already known about this topic? Systemic lupus erythematosus (SLE) is known to be a risk factor for pre‐eclampsia (PE). Second trimester uterine artery (UtA) Doppler is considered the gold standard for the screening of PE even if there are no randomized trials reported on its use in high‐risk women. UtA Doppler screening for PE has been tested in small case–control studies of SLE women. The prevalence of PE in SLE patients is reported to be around 10%. What does this study add? This study shows that UtA pulsatility at 23 + 0–26 + 6 weeks of gestation is a sensitive and specific test for PE in women with SLE UtA pulsatility also has a high specificity for small for gestational age infants and composite adverse pregnancy outcome in women with SLE This study shows that, if SLE is under control at conception, the incidence of pre‐eclampsia in women with SLE is lower than previously reported.