{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:14:30Z","timestamp":1790615670654,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T00:00:00Z","timestamp":1737158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the maternal hemodynamic profile at 12\u2009+\u20090 to 15\u2009+\u20096\u2009weeks' gestation in women who subsequently developed pre\u2010eclampsia (PE) and those who did not, and to assess the screening performance of maternal hemodynamic parameters for PE in combination with the Fetal Medicine Foundation (FMF) triple test, including maternal factors (MF), mean arterial pressure (MAP), uterine artery pulsatility index and placental growth factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective case\u2013control study involving Chinese women with a singleton pregnancy who underwent preterm PE screening at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks' gestation using the FMF triple test, between February 2020 and February 2023. Women identified as being at high risk (\u2265\u20091:100) for preterm PE by the FMF triple test were matched 1:1 with women identified as low risk (&lt;\u20091:100) for maternal age\u2009\u00b1\u20093\u2009years, maternal weight\u2009\u00b1\u20095\u2009kg and date of screening\u2009\u00b1\u200914\u2009days. Two\u2010dimensional transthoracic echocardiography was performed at 12\u2009+\u20090 to 15\u2009+\u20096\u2009weeks to evaluate maternal hemodynamic parameters (heart rate (HR), stroke volume (SV), cardiac output (CO) and systemic vascular resistance (SVR)). Maternal hemodynamic parameters were expressed as multiples of the median (MoM) values, determined by linear regression models to adjust for gestational age (GA) and MF. The distribution of log<jats:sub>10<\/jats:sub>\u2009MoM values of maternal hemodynamic parameters in cases of PE and unaffected pregnancies, and the association between these hemodynamic parameters and GA at delivery, were assessed. The risks of preterm PE (delivery before 37\u2009weeks) and any\u2010onset PE (delivery at any time) were reassessed using Bayes' theorem after maternal hemodynamic parameters were added to the FMF triple test. The screening performance for preterm PE and any\u2010onset PE was determined by the area under the receiver\u2010operating\u2010characteristics curve (AUC) and detection rate at a 10% fixed false\u2010positive rate (FPR). Differences in AUC (\u0394AUC) were assessed using DeLong's test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 743 cases were analyzed, of whom 39 (5.2%) subsequently developed PE, including 29 (3.9%) cases of preterm PE and 10 (1.3%) cases of term PE. Mean log<jats:sub>10<\/jats:sub>\u2009SVR MoM was significantly higher in cases of preterm PE and any\u2010onset PE compared with unaffected pregnancies. Mean log<jats:sub>10<\/jats:sub>\u2009SV MoM and log<jats:sub>10<\/jats:sub>\u2009CO MoM were significantly lower in cases of preterm PE and any\u2010onset PE compared with unaffected pregnancies. Mean log<jats:sub>10<\/jats:sub>\u2009HR MoM was not significantly different between the study groups. Mean log<jats:sub>10<\/jats:sub>\u2009CO MoM and log<jats:sub>10<\/jats:sub>\u2009SVR MoM were not significantly correlated with GA at delivery in preterm PE and any\u2010onset PE. For the prediction of preterm PE and any\u2010onset PE, adding CO or SVR or replacing MAP with CO and SVR in the FMF triple test achieved an identical or greater AUC compared with the FMF triple test, but \u0394AUC was not significantly different. In addition, adding CO or SVR or replacing MAP by CO and SVR in the FMF triple test did not improve the detection rate for preterm PE and any\u2010onset PE at a fixed FPR of 10%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with preterm PE or any\u2010onset PE exhibited increased SVR and decreased CO before the clinical manifestations of PE became apparent. These changes may serve as early indicators of cardiovascular maladaptation. However, assessment of maternal hemodynamics at 12\u2009+\u20090 to 15\u2009+\u20096\u2009weeks does not enhance the screening performance for preterm PE and any\u2010onset PE of these parameters. The FMF triple test remains superior to other biomarker combinations for predicting PE. \u00a9 2025 The Author(s). <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.29177","type":"journal-article","created":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T09:03:21Z","timestamp":1737191001000},"page":"173-182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prediction of pre\u2010eclampsia using maternal hemodynamic parameters at 12 + 0 to 15 + 6 weeks"],"prefix":"10.1002","volume":"65","author":[{"given":"X.","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3755-2701","authenticated-orcid":false,"given":"D. S.","family":"Sahota","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Shenzhen Research Institute The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6450-0241","authenticated-orcid":false,"given":"L.","family":"Nguyen\u2010Hoang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. S. T.","family":"Tai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Ling","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. P. W.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Therapeutics, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-4130","authenticated-orcid":false,"given":"L. C.","family":"Poon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Shenzhen Research Institute The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2009.02.010"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.07.020"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19112"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.08.034"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14970"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2455-8"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.09.041"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.122.19346"},{"issue":"6","key":"e_1_2_7_10_1","first-page":"1061","article-title":"Maternal hemodynamics in normal and preeclamptic pregnancies: a longitudinal study","volume":"76","author":"Easterling TR","year":"1990","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.10.226"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335366"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0960-7692.2001.00594.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5402"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14811"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/FM9.0000000000000101"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21905"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6340"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1247"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.02.018"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0100180"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.11.002"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2018.05.004"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/39.4.561"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(93)90405-8"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000298622.22494.0c"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01577.x"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17379"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2023.2198063"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11092"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17455"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19039"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S283239"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1009982611386"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181f08a5b"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23668"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.29177","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T21:32:10Z","timestamp":1757107930000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.29177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,18]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1002\/uog.29177"],"URL":"https:\/\/doi.org\/10.1002\/uog.29177","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,18]]},"assertion":[{"value":"2024-05-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}