Doppler de arterias uterinas en embarazadas hipertensas crónicas como predictor de preeclampsia con criterios de severidad sobreagregada y necesidad de cuidados intensivos

OBJECTIVE: To evaluate the usefulness of Doppler ultrasound of the uterine arteries performed between 18 and 23 weeks in chronically hypertensive pregnant women as a predictor of preeclampsia with criteria of severity or need for intensive care. MATERIALS AND METHODS: Prospective cohort study of diagnostic technology evaluation carried out in an institution in eastern Colombia with pregnant patients, chronic hypertensive, attended between April 2013 and September 2020. followed until the end of pregnancy, in whom Doppler ultrasound of the uterine arteries was performed between 18 to 23 weeks of pregnancy and subsequent evaluation of three outcomes: occurrence of preeclampsia, preeclampsia with severity criteria or need for intensive care. Markers of diagnostic performance and concordance beyond chance were estimated. RESULTS: 104 patients with age limits of 18 and 44 years were captured. Of the Doppler ultrasound scans performed, 31 (29.8%) were positive. After these, 73 (70.1%) patients had preeclampsia; 27 (37.0%) reached term, 17 (23.2%) terminated between 34.0 and 36.6 weeks, 21 (28.8%) between 24.0 and 33.6 weeks, and 8 (10.9%) before fetal viability. The negative predictive value for intensive care was 97.0%. In patients with positive proteinuria at the time of ultrasound, the sensitivity and positive predictive value was 100.0%. A positive report implied a relative risk of 2.18 (95%CI: 1.59-2.98) for severe preeclampsia and 5.61 (95%CI: 1.32-23.90) for the need for intensive care. CONCLUSION: Doppler ultrasound of the uterine arteries in chronically hypertensive pregnant women is predictive of risk of severe preeclampsia and need for intensive care, particularly if they have significant proteinuria at the time of examination.