Maternal ophthalmic artery Doppler velocimetry in pre-eclampsia in Southwestern Nigeria

Preeclampsia Management and Maternal Ophthalmic Artery Doppler Measurements between 19 and 23 Weeks of Gestation

Background: The ophthalmic Doppler is a reliable and impartial way to assess the severity of preeclampsia (PE). The study aimed to assess the potential utility of Doppler measurements of the maternal ophthalmic arteries during the weeks 19-23 of gestation, both independently and in combination with established biomarkers for PE. Methods: A prospective cohort study was conducted involving women who were recruited from a variety of standard appointments, including booking, scanning, and regular prenatal visits. A total of 200 women that were divided into high-risk and low-risk groups for developing PE were involved during the period between April 2023 and November 2023. Results: The ophthalmic ratio had significantly higher values in high-risk patients than in low-risk women (p = 0.000). There was a significant relationship between PSV2/PSV1 and gestational age at birth in women with PE compared to the ones who did not develop PE. Conclusions: An ophthalmic artery Doppler can play a crucial role in the early detection of PE, allowing for timely intervention and management. Incorporating the ophthalmic artery Doppler as a screening tool for PE in Bulgaria has the potential to improve early detection, risk stratification, and overall maternal and fetal health outcomes.

A Correlational Study of Ophthalmic Artery Doppler Parameters and Maternal Blood Pressure in Normotensive and Pre-eclamptic Pregnancies at a Tertiary Care Hospital

Background Hypertensive disorders are one of the most common complications of pregnancy. This study aimed to investigate the relationship between ophthalmic artery Doppler indices and preeclampsia development and evaluate differences in these indices between normotensive and hypertensive pregnancies. Methods A hospital-based cross-sectional observational study was conducted involving a sample size of 80 pregnant women: 40 normotensive and 40 preeclamptic. The participants' ophthalmic artery Doppler parameters were evaluated using ultrasonography. Various clinical and demographic factors were also collected for analysis. Results Significant differences in the pulsatility index (PI) and end-diastolic volume (EDV) of the ophthalmic arteries were found between the normotensive and preeclamptic participants (p < 0.05). An inverse correlation was observed between the ophthalmic artery PI (OAPI) and mean maternal arterial pressure, suggesting reduced orbital vascular resistance and increased orbital flow. Moreover, the decrease in PI was more significant in severely preeclamptic women than in mildly preeclamptic and normotensive women. The findings indicated a significant correlation between ophthalmic artery Doppler parameters and the development of preeclampsia. The decrease in OAPI was particularly profound in women with severe preeclampsia. However, the study was limited by its small sample size and the lack of matching of participants based on maternal age, gestational age, and other factors. Conclusions The study results suggest that ophthalmic artery Doppler parameters, mainly PI and EDV, could serve as reliable indicators for the development of preeclampsia. Given their safety, cost-effectiveness, and accessibility, these parameters can help differentiate between preeclamptic and normotensive pregnancies in late gestation. Further research with larger sample sizes and matched participant groups is recommended for more conclusive results.

Ophthalmic artery Doppler in the complementary diagnosis of preeclampsia: a systematic review and meta-analysis

OBJECTIVE

To evaluate the accuracy of different parameters of the ophthalmic artery Doppler (OAD) in the complementary diagnosis of preeclampsia (PE).

METHODS

This meta-analysis adhered to the PRISMA guidelines. To investigate the mean difference in OAD values, peak systolic velocity (PSV), end-diastolic velocity (EDV), second systolic velocity peak (P2), resistance index (RI), pulsatility index (PI), and peak ratio (PR), between PE cases (overall and according to severity) and controls, random-effects meta-analyses were conducted for each Doppler parameter, with overall PE and mild and severe PE subgroups. Diagnostic performance and heterogeneity were evaluated with summary receiver operating characteristic (sROC) curves and 95% confidence intervals obtained with bivariate models.

RESULTS

Eight studies stratified the results into mild and severe or late and early PE, involving 1,425 pregnant women. PR and P2 had better diagnostic performance than the other indexes, with the PR of AUsROC at 0.885, the sensitivity of 84%, and specificity of 92%, with a low false-positive rate of 0.08 and the P2 with AUsROC of 0.926, the sensitivity of 85% and specificity of 88%. RI, PI, and EDV showed good performance and consistency across studies but lower AUsROC values of 0.833, 0.794, and 0.772, respectively.

CONCLUSION

Ophthalmic artery Doppler is a complementary tool with good performance for the diagnosis of overall and severe preeclampsia, with high and best sensitivity and specificity when using PR and P2 parameters.

Case-control study on ocular changes and ophthalmic Doppler velocimetric indices among preeclamptic and normotensive pregnant women in Ibadan, Nigeria

Objective

To compare the ocular changes and Doppler velocimetric indices in preeclamptic and normotensive pregnant women.

Methods and analysis

This was a case-control study of 71 preeclamptic women and 72 parity-matched normotensive pregnant women conducted at the University College Hospital, Ibadan, Nigeria. Demographic data were obtained using questionnaires. All participants had visual acuity assessment, funduscopy, intraocular pressure measurement and orbital Doppler ultrasonography. The differences in parameters between the two groups were tested using Student’s t-test for quantitative variables and χ² tests for categorical variables.

Results

There were no significant differences between cases and controls with respect to sociodemographic variables. The mean pulsatility index was 1.35±0.46 in cases and 2.1±0.4 in controls (p<0.001); the resistivity index was 0.7±0.18 in cases and 0.83±0.27 among the controls (p=0.01). A similar pattern was observed in the peak systolic velocity (p<0.001) and the peak ratio (p<0.001). There was no significant difference between the groups concerning end-diastolic velocity (p=0.535). Three preeclampsia patients (5.2%) had abnormalities on funduscopy compared with none of the controls. Preeclamptic women had significantly higher intraocular pressures in both eyes at baseline and at 24 hours post delivery.

Conclusion

This study demonstrated lower Doppler velocimetry and impedance parameters and higher intraocular pressure among preeclampsia cases compared with controls. Abnormal funduscopic findings were observed in a few preeclamptic women and none among the controls. Ophthalmic artery Doppler parameters could be useful in identifying those women who are likely to suffer preeclampsia and its complications.

KIR2DL4 expression rather than its single nucleotide polymorphisms correlates with pre-eclampsia

OBJECTIVE

To evaluate the single nucleotide polymorphisms and expression of KIR2DL4 (killer cell immunoglobulin-like receptors) gene in pre-eclampsia patients.

METHODS

KIR2DL4 gene polymorphisms were detected in 100 patients with pre-eclampsia and 100 healthy pregnant women, respectively, by using PCR-SS. Then, the expression of KIR2DL4 was measured in 5 cases of placentas tissues with pre-eclampsia and normal pregnancies by using qRT-PCR.

RESULTS

Compared with healthy controls, 16 loci of single nucleotide polymorphisms (SNP) were identified in pre-eclampsia patients, including 7 new polymorphisms loci. But, no significant difference was found in genotype distributions and allele frequencies in pre-eclampsia and controls (P>0.05). However, qRT-PCR results showed that KIR2DL4 mRNA in placenta tissues with pre-eclampsia was significantly lower than those with normal pregnancy, and the difference was statistically significant.

CONCLUSION

Decreased level of KIR2DL4 rather than its SNP is correlated with the susceptibility of pre-eclampsia.