Role of First-Trimester Ophthalmic Artery Doppler in Predicting Eclampsia: A Prospective Observational Study

Abstract

Introduction: Eclampsia is a severe complication of hypertensive disorders of pregnancy associated with substantial maternal and fetal morbidity. Ophthalmic artery Doppler provides a non-invasive assessment of maternal cerebrovascular hemodynamics and may facilitate early identification of women at risk.

Aim & Objective: To evaluate first-trimester ophthalmic artery Doppler parameters and their association with subsequent development of eclampsia.

Materials & Methods: This prospective observational study included 10 pregnant women who underwent ophthalmic artery Doppler ultrasonography at 11 weeks to 13 weeks and 6 days of gestation and were subsequently followed for development of eclampsia. Resistance index (RI), pulsatility index (PI), peak systolic velocity ratio (P2/P1), and second peak systolic velocity (PSV2) were evaluated. Doppler parameters were compared between women who developed eclampsia and those who did not.

Results: Seven (70%) women developed eclampsia. Compared with women without eclampsia, those who developed eclampsia had significantly lower RI (0.573 vs 0.627; p=0.033) and PI (1.05 vs 1.37; p=0.039) and a significantly higher P2/P1 ratio (0.779 vs 0.653; p=0.033). PSV2 was higher in the eclampsia group (46.43 vs 41.97 cm/s), although the difference was not statistically significant (p=0.067). A P2/P1 ratio >0.65 demonstrated 100% sensitivity, 66.7% specificity, 87.5% positive predictive value, and 100% negative predictive value.

Conclusion: First-trimester ophthalmic artery Doppler demonstrates promising hemodynamic alterations associated with subsequent eclampsia. Reduced RI and PI and an increased P2/P1 ratio may aid early risk stratification; however, larger prospective studies are required to validate these preliminary findings.

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