Arterial resistance in late first trimester as a predictor of subsequent pregnancy-related hypertension

Objectives: this study aimed to examine the association between indicators of arterial resistance occurring late in the first trimester and the subsequent development of pregnancy-related hypertension. methods: this study took place between may 2014 and august 2015 and included 329 consecutive women with singleton pregnancies attending the antenatal clinics of a medical college in karnataka,india,during this period. pulse pressure (pp) and uterine artery doppler parameters were recorded between 11–14 gestational weeks. consequently,women were followed-up until after delivery for subsequent hypertension. results: hypertension occurred more frequently if pp was high (17.6% versus 14.4% of pregnancies without high pp; p = 0.713),if a diastolic notch (dn) was present (15.1% versus 12.8% of pregnancies with an absent dn; p = 0.612) and if the resistive index (ri) was raised (22.2% versus 14.3% of pregnancies without raised ri; p = 0.366). a raised pulsatility index (pi) was significantly associated with hypertension (p = 0.013). the risk of hypertension was approximately seven-fold higher if two or more arterial resistance indicators were used,except with a present dn plus a raised ri or a present dn plus high pp. all arterial resistance indicators showed negative predictability (>85.6%) and good specificity (≥95.0%),except for the presence of a dn. a population-specific cut-off pi value of 1.72 had high negative predictability (92.8%) and good sensitivity (70.8%) and specificity (65.1%). conclusion: raised pi in the late first trimester was a significant predictor of hypertension later in pregnancy. a combination of arterial resistance indicators may enhance prediction of subsequent hypertension. © 2016,sultan qaboos university. all rights reserved.