A systematic literature search and meta-analysis were conducted to evaluate the sensitivity and specificity of the pulsatility index of Doppler ultrasound of uterine arteries for predicting preeclampsia. The timing of ultrasound scans within and beyond 20 weeks of gestational age was compared to assess its effect on the sensitivity and specificity of the pulsatility index.
This meta-analysis included 27 studies and 81,673 subjects (3309 preeclampsia patients and 78,364 controls). The pulsatility index had moderate sensitivity (0.586) and high specificity for predicting preeclampsia (0.879) (summary point: sensitivity 0.59; 1-specificity 0.12). Subgroup analysis revealed that ultrasound scans performed within 20 weeks of gestational age did not significantly affect the sensitivity and specificity for predicting preeclampsia. The summary receiver operator characteristic curve showed the pulsatility index\'s optimal range of sensitivity and specificity.
The uterine arteries pulsatility index measured by Doppler ultrasound is useful and effective for predicting preeclampsia and should be implemented in the clinical practice. The timing of ultrasound scans at different gestational age ranges does not significantly affect the sensitivity and specificity.
方法:采用系统的文献检索和荟萃分析评价子宫动脉多普勒超声搏动指数预测子痫前期的敏感性和特异性。比较了胎龄20周以内和以后的超声扫描时间,以评估其对搏动指数的敏感性和特异性的影响。
结果:这项荟萃分析包括27项研究和81,673名受试者(3309名先兆子痫患者和78,364名对照)。搏动指数对预测先兆子痫具有中等敏感性(0.586)和高特异性(0.879)(总结点:敏感性0.59;1特异性0.12)。亚组分析显示,在孕龄20周内进行的超声扫描并未显着影响预测先兆子痫的敏感性和特异性。摘要接受者操作员特征曲线显示了搏动指数的灵敏度和特异性的最佳范围。
结论:多普勒超声测量子宫动脉搏动指数对预测子痫前期是有用且有效的,应在临床上推广。不同胎龄范围超声扫描的时机对敏感性和特异性无明显影响。