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Objective: Pre-eclampsia is a serious complication of pregnancy with high mor bidity and mortality and an incidence of 3-5%in all pregnancies. Early predict ion is still insufficient in clinical practice. Although most pre-eclamptic pat ients have pathological uterine perfusion in the second trimester, perfusion dis turbance has a positive predictive accuracy(PPA) only of approximately 30%. Met hods: Non-invasive continuous blood pressure recordings were taken simultaneous ly via a finger cuff for 30 min. Time series of systolic as well as diastolic be at-to-beat pressure values were extracted to analyse heart rate and blood pres sure variability and baroreflex sensitivity in 102 second-trimester pregnancies , to assess predictability for pre-eclampsia(n=16). All women underwent Doppler investigations of the uterine arteries. Results: We identified a combination of three variability and baroreflex parameters to best predict pre-eclampsia seve ral weeks before clinical manifestation. The discriminant function of these thre e parameters classified patients with later pre-eclampsia with a sensitivity of 87.5%, a specificity of 83.7%, and a PPA of 50.0%. Combined with Doppler inv estigations of uterine arteries, PPA increased to 71.4%. Conclusions: This tech nique of incorporating onestop clinical assessment of uterine perfusion and vari ability parameters in the second trimester produces the most effective predictio n of pre-eclampsia to date.
Objective: Pre-eclampsia is a serious complication of pregnancy with high mor bidity and mortality and may be of 3-5% in all pregnancies. Early predict ion is still insufficient in clinical practice. Although most pre-eclamptic patients have pathological uterine perfusion in the second trimester, perfusion dis turbance has a positive predictive accuracy (PPA) only of approximately 30%. Met hods: Non-invasive continuous blood pressure recordings were taken simultaneous ly via a finger cuff for 30 min. Time series of systolic as well as diastolic be at-to-beat pressure values were extracted to analyze heart rate and blood pres sure variability and baroreflex sensitivity in 102 second-trimester pregnancies, to assess predictability for pre-eclampsia (n = 16). All women underwent Doppler investigations of the uterine arteries. Results: We identified a combination of three variability and baroreflex parameters to best predict pre-eclampsia seve ral weeks before clinical manifestation. Th e discriminant function of these threes parameters classified patients with later pre-eclampsia with a sensitivity of 87.5%, a specificity of 83.7%, and a PPA of 50.0%. Combined with Doppler inv estimates of uterine arteries, PPA increased to 71.4%. Conclusions: This tech nique of incorporating onestop clinical assessment of uterine perfusion and vari ability parameters in the second trimester produces the most effective predictio n of pre-eclampsia to date.