780: First trimester dried blood ADAM-12 as a marker for preterm severe pre-eclampsia (PEC) and intrauterine growth restriction (IUGR)

Introdução: O conceito de restrição do crescimento fetal tardio (CFT) foi introduzido para descrever fetos com insuficiência placentária que não é grave o suficiente para resultar em CFT com fluxo arterial umbilical anormal, mas é grave o suficiente para associar-se com alto risco perinatal ou complicações de longo prazo. Entretanto, há necessidade de retroceder a investigação para o primeiro trimestre, na esperança de possível intervenção. Objetivo: Realizar revisão bibliográfica do tema. Material e Métodos: As palavras-chave CIUR (crescimento intrauterino restrito) e IUGR (intrauterine growth restriction) foram identificadas na Biblioteca Virtual em Saúde (BVS). O termo CIUR também foi pesquisado na Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), nos últimos dez anos. Com o auxílio do Endnote, foram realizadas pesquisas no PubMed usando a palavra-chave (MeSH term) intrauterine growth restriction (IUGR), no período 2011‒2020. Os artigos foram baixados e foi montada uma pasta com eles em formato pdf. Posteriormente, foram importados pelo Endnote. Resultados: Na LILACS, nos últimos 10 anos, foram recuperados 20 artigos com texto completo. No PubMed, no período 2011‒2020 (até agosto), foram identificadas 5.551 referências sob o título “intrauterine growth restriction”. Utilizando como filtro a expressão “first trimester”, restaram 370 referências, e após um segundo filtro (“screening”), 308 referências. Destas, conseguimos os textos completos em .pdf de 101, que foram utilizados para a presente revisão. Modelos foram identificados incluindo dados clínicos maternos (método de contracepção, tabagismo, altura materna), métodos de imagem (Doppler da artéria uterina, avaliando o índice de pulsatilidade — PI) e avaliação bioquímica (fator de crescimento placentário — PlGF, gonadotrofina coriônica — βhCG, pregnancy-associated plasma protein-A — PAPP-A, soluble fms-like tytosine kinase — sFlt-1 e disintegrin and metalloprotease — ADAM 12). Conclusão: Neste estudo, foram utilizados diferentes modelos com associação dos fatores mencionados anteriormente. Ainda não se identificou o modelo ideal, necessitando de novos estudos.

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Is ProBNP a New Marker for Predicting Intrauterine Growth Restriction?

Zeitschrift für Geburtshilfe und Neonatologie ◽

10.1055/a-1382-8787 ◽

2021 ◽

Vol 225 (02) ◽

pp. 125-128

Author(s):

Hasan Eroğlu ◽

Nazan Vanlı Tonyalı ◽

Gokcen Orgul ◽

Derya Biriken ◽

Aykan Yucel ◽

...

Keyword(s):

Intrauterine Growth Restriction ◽

Final Analysis ◽

First Trimester ◽

Maternal Serum ◽

Growth Restriction ◽

Control Group ◽

Aneuploidy Screening ◽

Intrauterine Growth ◽

Potential Marker ◽

The Mean

Abstract Purpose To evaluate the usability of first-trimester maternal serum ProBNP levels in the prediction of intrauterine growth restriction (IUGR). Methods In this prospective study, blood samples taken from 500 women who applied to our polyclinic for routine serum aneuploidy screening between the 11–14th gestational weeks were centrifuged. The obtained plasma samples were placed in Eppendorf tubes and stored at −80+°C. For the final analysis, first-trimester maternal serum ProBNP levels of 32 women diagnosed with postpartum IUGR and 32 healthy women randomly selected as the control group were compared. FGR was defined as estimated fetal weight below the 10th percentile for the gestational age. Results The mean ProBNP levels were statistically and significantly higher in the women with intrauterine growth restriction (113.73±94.69 vs. 58.33±47.70 pg/mL, p<0.01). At a cut-off level of 50.93, ProBNP accurately predicted occurrence of IUGR (AUC+= 0.794 (95% confidence interval 0.679–0.910), p+= 0.001) with sensitivity and specificity rates of 78.1 and 69.0%, respectively. Conclusion First-trimester serum ProBNP level was significantly higher in women who developed IUGR compared to healthy controls. First-trimester ProBNP level can be used as a potential marker to predict the development of IUGR in pregnant women.

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First trimester uterine artery Doppler and subsequent intrauterine growth restriction and preterm birth

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2004.09.085 ◽

2004 ◽

Vol 191 (6) ◽

pp. S22

Author(s):

Lorraine Dugoff ◽

John Hobbins ◽

Vincent Faber ◽

Fergal Malone ◽

Michael Belfort ◽

...

Keyword(s):

Preterm Birth ◽

Intrauterine Growth Restriction ◽

Uterine Artery ◽

First Trimester ◽

Growth Restriction ◽

Uterine Artery Doppler ◽

Intrauterine Growth

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First trimester uterine artery Doppler abnormalities predict subsequent intrauterine growth restriction

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2005.06.054 ◽

2005 ◽

Vol 193 (3) ◽

pp. 1208-1212 ◽

Cited By ~ 67

Author(s):

Lorraine Dugoff ◽

Anne M. Lynch ◽

Darleen Cioffi-Ragan ◽

John C. Hobbins ◽

Lisa K. Schultz ◽

...

Keyword(s):

Intrauterine Growth Restriction ◽

Uterine Artery ◽

First Trimester ◽

Growth Restriction ◽

Uterine Artery Doppler ◽

Intrauterine Growth

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First trimester screening for pre-eclampsia and intrauterine growth restriction using three-dimensional Doppler angiography (SPIRIT): protocol for a multicentre prospective study in nulliparous pregnant women

BMJ Open ◽

10.1136/bmjopen-2020-037751 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037751

Author(s):

Charline Bertholdt ◽

Gabriela Hossu ◽

Claire Banasiak ◽

Marine Beaumont ◽

Olivier Morel

Keyword(s):

Pregnant Women ◽

Intrauterine Growth Restriction ◽

Power Doppler ◽

First Trimester ◽

Growth Restriction ◽

Flow Index ◽

Intrauterine Growth ◽

Uncomplicated Pregnancy ◽

Nulliparous Women ◽

Biomarker Analysis

IntroductionPre-eclampsia (PE) and intrauterine growth restriction (IUGR) are two major pregnancy complications, related to chronic uteroplacental hypoperfusion. Nowadays, there is no screening or diagnostic test for uteroplacental vascularisation deficiency in pregnant women. Since 2004, 3 three-imensional power Doppler (3DPD) angiography has been used for the evaluation of uteroplacental vascularisation and three vascular indices are usually calculated: Vascularisation Index (VI), Flow Index (FI) and vascularisation-FI (VFI). A high intraobserver and interobserver reproducibility and a potential interest for placental function study were reported by our team and others.The main objective of our study is to determine differences in 3DPD indices at first trimester between pregnancies defined at their outcome as uncomplicated pregnancy, PE (mild and severe) and IUGR in nulliparous women.Methods and analysisThis is a national multicentre prospective cohort study conducted in four French maternity units. We expect to include 2200 women in a period of 36 months. The nulliparous pregnant women will be recruited during their first trimester consultation (11–13+6 gestation week (GW)).The 3DPD and uterine artery Doppler acquisition will be included in the current routine 11–13+6 GW ultrasound. Also, additional blood samples will be taken for biomarker analysis (PAPP-A and P1GF) and biological collection. Uteroplacental VIs (FI and VFI) will be measured. For each subgroup (uncomplicated pregnancy, PE and IUGR), mean values in 3DPD indices will be computed and compared using a pairwise t test with a Bonferroni correction p value adjustment.Ethics and disseminationThe study was approved by the French Ethics Committee, the Comité de Protection des Personnes SUD MEDITERRANEE IV on 13 February 2018 with reference number 17 12 03. The results of this study will be published in a peer-reviewed journal and will be presented at relevant conferences.Trial registration numberNCT03342014; Pre-results. PHRCN-16-0567.

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