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Author: search.filters.author.Marcelo LlancaqueoSubject: search.filters.subject.doppler ultrasonography

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    Item type:Publication,
    Perinatal outcomes of pregestational hypertension according to blood pressure range at 11–14 week scan: Impact of the 2017 ACC/AHA guidelines
    (2022)
    Alvaro Sepúlveda-Martínez
    ;
    Tomas Conrads
    ;
    Rodolfo Guiñez
    ;
    Javiera Guiñez
    ;
    Marcelo Llancaqueo
    <jats:sec><jats:title>Objective</jats:title><jats:p>The aim of this study was to evaluate the impact on perinatal outcomes related to placental insufficiency with the application of the new 2017 ACC/AHA guidelines to a group of chronic hypertensive pregnancies during their first-trimester assessment.</jats:p></jats:sec><jats:sec><jats:title>Study design</jats:title><jats:p>This retrospective cohort study included pregnancies with preconceptional hypertension and known perinatal outcomes. In the first trimester, a combined screening for preterm preeclampsia (p-PE) was performed, including blood pressure (BP), mean uterine artery Doppler, and maternal characteristics. Patients were divided, according to the 2017 ACC/AHA consensus, into the following groups: elevated or less, Stage 1, and Stage 2. For adverse perinatal outcome assessment, univariate and multivariate regression analyses were performed, considering the “elevated or less” group as a reference. Odds ratios (OR) were compared with linear trend analysis. The main outcomes measured were preterm PE and FGR &amp;lt; 3<jats:italic><jats:sup>rd</jats:sup></jats:italic> percentile.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of the 130 included patients, 59 (45.4%) were classified as elevated or less, 47 (36.2%) as Stage 1, and 24 (18.4%) as Stage 2. p-PE showed a significant increase according to BP range [7% (OR = 1.0), 19.6% (OR = 3.2), and 21.7% (OR = 3.7)]; trend p = 0.02, for elevated or less, Stage 1, and Stage 2, respectively. There was a non-significant increased trend of FGR &amp;lt; 3<jats:italic><jats:sup>rd</jats:sup></jats:italic> percentile according to the BP stage. The best multivariate predictive model for p-PE included a previous PE background (OR = 15) and mean arterial pressure in mmHg (OR = 1.1).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The use of the 2017 ACC/AHA consensus in pregnancies with chronic hypertension identifies an intermediate risk group for placental-mediated diseases.</jats:p></jats:sec>
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