Desempenho da Calculadora de Risco para Pré-eclâmpsia disponibilizado pela Fetal Medicine Foundation (FMF) associado à ultrassonografia de primeiro trimestre para triagem de pré-eclâmpsia em gestantes

Abstract

According to the Brazilian Medical Association guidelines regarding prenatal care, it is established that the minimum number of queries in this period should be six, one in the first quarter, two in the second quarter and three in the last trimester of pregnancy. The largest number of consultations in late pregnancy is due to the evaluation of pregnant women in relation to perinatal risk and events that usually occur during this period as preeclampsia (PE), a leading cause of maternal death. The pathophysiology of PE isn't fully understood yet, being regarded as a multifactorial origin pathology, for which immunological, genetic and environment aspects, are associated. The precocious identification of potential pregnant women who might develop PE could be a very useful tool, because prophylactic therapy could help, a lot, such pregnancies development with better results. Thus, this study aimed to evaluate the performance, in terms of sensitivity and specificity, the Preeclampsia Risk Calculator available by the Fetal Medicine Foundation (FMF) to screen pregnant women who are in the first trimester of pregnancy, using ultrasound in the evaluation about the risk of PE (early, intermediate and late), without serum markers. Therefore, the data of 195 pregnant women, obtained by questionnaire, routine ultrasound exams on the first quarter and medium arterial pressure were tested with this method for calculation of PE risk. The considered reference standard was the confirmation of PE actual development in the three described stages. Performance calculations tests were performed using the Prism5® for Windows, assuming a significance level of 0.05 and also graphically processed (ROC curves). Results showed greater sensitivity just to late PE risk (85.7%) compared to early (75%) and intermediate (80%), with specificity of 82.4% (late PE), 91.2% for intermediate and 98.2% for early. We can conclude, then, that for the first trimester of pregnancy, the Risk Calculator for Preeclampsia (FMF) was a useful tool and applicable in the assessment of PE calculated risk in Brazilian pregnant women.