Revista chilena de obstetricia y ginecología
versión ISSN 0717-7526
SAEZ O, Nicolás y CARVAJAL C, Jorge. Tamizaje y prevención de pre-eclampsia guiado por Doppler de arterias uterinas: revisión sistemática de la literatura. Rev. chil. obstet. ginecol. [online]. 2012, vol.77, n.3, pp. 235-242. ISSN 0717-7526. doi: 10.4067/S0717-75262012000300011.
Background: pre-eclampsia (PE) is a pregnancy-related severe disease with a prevalence of ~3%. Identification of women at risk may improve maternal and perinatal outcome. Estimate of PE individual risk would offer preventive treatment [ie: Aspirin (ASA)]. Uterine Artery Doppler (UAD) has been used in first and second trimester as a PE screening test. Aims: To gather the available evidence on PE prediction with UAD and the potential benefits of ASA use in these women. Methods: We searched on Pubmed, reviewing 32 original papers, 5 reviews and 1 meta-analysis. The study quality was analyzed with scientific literature review guidelines and diagnostic test analysis guidelines. Results: Literature analysis showed that UAD's best diagnostic capacity for early onset PE is through transvaginal mean pulsatility index measurement between 20th and 24th week in high risk population. Eighty five percent sensibility (85% specificity), with 18% PPV is achieved using p95 as a cut value. ASA is effective in preventing PE in high risk population, with 17% decrease in incidence but with no effect on maternal or perinatal morbid-mortality. Conclusion: UAD is useful in early onset PE screening in pregnant population selected by risk factors. Further studies are needed to direct ASA use as PE prophylaxis in this population.
Palabras clave : Preeclampsia; uterine artery doppler; screening; prevention.