{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T11:29:43Z","timestamp":1767007783754,"version":"3.33.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,2]],"date-time":"2024-06-02T00:00:00Z","timestamp":1717286400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine the postnatal course of ophthalmic artery (OA) Doppler in women with hypertensive disorders of pregnancy (HDP) and to evaluate the correlation between OA Doppler parameters and poor postnatal blood pressure control and renal dysfunction at 2\u20133\u2009weeks and 6\u20139\u2009weeks postnatally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective cohort study of women with a singleton pregnancy and HDP seen at a tertiary pregnancy hypertension clinic between 2019 and 2021. Three visits were included: Visit 1, the last visit to the antenatal hypertension clinic within 2\u2009weeks prior to delivery; Visit 2, at 2\u20133\u2009weeks postnatally; and Visit 3, at 6\u20139\u2009weeks postnatally. At each visit, maternal demographic characteristics, medical history, blood pressure and OA Doppler were obtained. In addition, fetal growth and fetal Dopplers were examined antenatally and, at 6\u20139\u2009weeks postnatally, estimated glomerular filtration rate and proteinuria were quantified. Study participants were divided into four hypertension groups, according to longitudinal changes in blood pressure at the three visits. For the postnatal visits, hypertension was defined as systolic blood pressure (SBP) \u2265\u2009140\u2009mmHg and\/or diastolic blood pressure (DBP) \u2265\u200990\u2009mmHg in the absence of antihypertensive medication, and SBP \u2265\u2009130\u2009mmHg and\/or DBP \u2265\u200980\u2009mmHg whilst taking antihypertensives. Group 1 was hypertensive at all three visits; Group 2 was hypertensive at Visits 1 and 2 but normotensive at Visit 3; Group 3 was hypertensive at Visits 1 and 3 but normotensive at Visit 2; and Group 4 was hypertensive at Visit 1 but normotensive at Visits 2 and 3. The longitudinal changes in mean arterial pressure (MAP), peak systolic velocity (PSV) 1, PSV2 and the ratio of PSV2\/PSV1 over the three timepoints were examined by a repeated\u2010measures, multilevel, linear mixed\u2010effects analysis, controlling for maternal age, weight at presentation and use of antihypertensive medication. In addition, we examined the longitudinal change in OA Doppler parameters in women with different degrees of postnatal blood pressure control and in those with and those without renal dysfunction at 6\u20139\u2009weeks postnatally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 108 women were recruited to the study, of whom 86 had new\u2010onset hypertension and 22 had chronic hypertension. When controlling for maternal age, weight at presentation and use of antihypertensive medication, a significant decline in log<jats:sub>10<\/jats:sub> MAP (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), log<jats:sub>10<\/jats:sub> PSV1 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and log<jats:sub>10<\/jats:sub> PSV2 (<jats:italic>P<\/jats:italic>\u2009=\u20090.01) was seen between Visits 1 and 3. Log<jats:sub>10<\/jats:sub> PSVR did not change with time. When assessing OA Doppler against hypertension group, log<jats:sub>10<\/jats:sub> PSV1 and log<jats:sub>10<\/jats:sub> PSV2 did not differ between the hypertension groups, whilst Group 4 had a lower log<jats:sub>10<\/jats:sub> PSVR compared with Group 1 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), Group 2 (<jats:italic>P<\/jats:italic>\u2009=\u20090.03) and Group 3 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). At 6\u20139\u2009weeks postnatally, log<jats:sub>10<\/jats:sub> PSVR was lower in those without compared to those with renal dysfunction (\u22120.021, <jats:italic>P<\/jats:italic>\u2009=\u20090.01), whilst log<jats:sub>10<\/jats:sub> MAP, log<jats:sub>10<\/jats:sub> PSV1 and log<jats:sub>10<\/jats:sub> PSV2 values did not differ. Log<jats:sub>10<\/jats:sub> PSVR did not change with time and remained at \u22120.12 (95%\u2009CI, \u22120.13 to \u22120.11) across the three visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women with HDP, the OA\u2010PSVR was significantly higher in those with labile or persistently raised blood pressure postnatally compared to women whose blood pressure normalized. Similarly, the OA\u2010PSVR at 6\u20139\u2009weeks postnatally was significantly higher in women with renal dysfunction <jats:italic>vs<\/jats:italic> those without dysfunction. \u00a9 2023 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.27563","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T15:25:31Z","timestamp":1703085931000},"page":"738-745","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ophthalmic artery Doppler in women with hypertensive disorders of pregnancy: relationship to blood pressure control and renal dysfunction at 6\u20139 weeks postnatally"],"prefix":"10.1002","volume":"63","author":[{"given":"K.","family":"Gy Lau","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Bednorz","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Parisi","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7992-6038","authenticated-orcid":false,"given":"N. A.","family":"Kametas","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,2]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"National Institue for Health and Care Excellence (NICE).Hypertension in pregnancy: how common is it?Accessed November 15 2023.https:\/\/cks.nice.org.uk\/topics\/hypertension\u2010in\u2010pregnancy\/background\u2010information\/prevalence\/."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03809-2"},{"key":"e_1_2_8_4_1","article-title":"ACOG Committee Opinion No. 736: optimizing postpartum care","volume":"131","author":"American College of Obstetricians and Gynecologists (ACOG)","year":"2018","journal-title":"ACOG Comm Opin"},{"key":"e_1_2_8_5_1","unstructured":"National Institute for Health and Care Excellence (NICE).Hypertension in pregnancy: diagnosis and management. NG 133. Accessed November 15 2023.https:\/\/www.nice.org.uk\/guidance\/ng133."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-021-01134-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24874"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17061"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2023.10.001"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000087"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MBP.0000000000000315"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23517"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_2_8_14_1","unstructured":"National Institute for Health and Care Excellence (NICE).Chronic kidney disease: assessment and management. NICE Guidline NG203. Accessed November 15 2023.https:\/\/www.nice.org.uk\/guidance\/ng203\/."},{"key":"e_1_2_8_15_1","first-page":"5","article-title":"KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"3","author":"Eknoyan G","year":"2013","journal-title":"Kidney Int"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.10803"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13522"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.4510"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.7.2.147"},{"key":"e_1_2_8_20_1","unstructured":"Office for National Statistics (ONS).Birth characteristics in England and Wales: 2021. 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