Monday, November 30 | 9:30 a.m. to 10:30 a.m. | M3-SSOB01-7 | Room S404
Can ultrasound at 16 to 20 weeks of pregnancy help identify women who will later develop gestational hypertension? In this presentation, researchers will evaluate second-trimester shear wave placental elastography and uterine artery Doppler indices, comparing their individual and combined performance.
Anurag Kumar, MBBS, will present results from the prospective observational cohort study that enrolled 100 pregnant women who underwent a routine second-trimester anatomic survey at a tertiary care center. Each participant underwent bilateral uterine artery Doppler, measuring mean pulsatility index (PI) and resistivity index (RI), and placental shear wave elastography. Women were followed until delivery.
Thirteen women (13%) developed gestational hypertension. Placental stiffness was significantly higher in that group (8.94 kPa vs. 5.41 kPa, p < 0.0001), as were mean PI (1.24 vs. 0.76) and mean RI (0.749 vs. 0.522).
Bilateral uterine artery notching appeared in 44.4% of those who developed hypertension versus 17.2% of controls. Elastography had the highest accuracy, with an AUC of 0.99, 100% sensitivity, 97.7% specificity, and 100% negative predictive value at a cutoff of 7.87 kPa. Mean RI had an AUC of 0.98 and mean PI an AUC of 0.95. Elastography was the strongest independent predictor on regression, and the combined model reached an AUC of 0.9991. Combining RI with elastography gave 92.3% sensitivity, 95.4% specificity, and 98.8% negative predictive value. Agreement was excellent for elastography (κ = 0.915).
The results show that second-trimester placental elastography is a highly accurate predictor of gestational hypertension and outperformed Doppler indices as a standalone test, while combining elastography with RI achieved near-perfect discrimination.
Attend this session to find out more.
