Idiopathic urinary findings and fetal growth restriction in low risk pregnancy

Objective: To investigate newborns’ sizes associated with abruptio placentae (AP) and to assess the association of a history of pregnancy induced hypertension (PIH) and low birth weight with the occurrence of AP and vice versa. Design: A cohort study based on the Medical Birth Registry of Norway. Results: AP in the first birth was associated with higher rates of AP, small for gestational age (SGA), and PIH in the second pregnancy. This was particularly evident for early onset preeclampsia (unadjusted odds ratio: 5.9; 95% confidence interval: 3.0–11.5). PIH in the first pregnancy was associated with higher rates of AP in the second. In women who delivered a newborn with weight below the 5th birth weight percentile, AP was 2–3 times more likely to occur than with birth weight percentiles 10–89.9. The occurrence of AP in the second pregnancy also increased with decreasing size at birth in the previous. Conclusions: A pregnancy subsequent to AP must be considered a risk pregnancy in terms of recurrent AP and excess risk of fetal growth restriction and PIH. In sibships with PIH, fetal growth restriction, or PA among siblings, the risk of AP is increased. This suggests a shared recurrent etiologic factor involving an abnormal feto-maternal relationship in AP, PIH, and fetal growth restriction.

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OP06.02: Conservative management of low‐risk late fetal growth restriction: an evidence‐based management protocol

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.23973 ◽

2021 ◽

Vol 58 (S1) ◽

pp. 76-77

Author(s):

R.L. Peasley ◽

D. Casagrandi ◽

V. Donadono ◽

G. Conti ◽

N. Marlow ◽

...

Keyword(s):

Fetal Growth ◽

Conservative Management ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Low Risk ◽

Evidence Based ◽

Management Protocol

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The ability of continuous-wave Doppler ultrasound to detect fetal growth restriction

PLoS ONE ◽

10.1371/journal.pone.0255960 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255960

Author(s):

Ute Feucht ◽

Helen Mulol ◽

Valerie Vannevel ◽

Robert Pattinson

Keyword(s):

Doppler Ultrasound ◽

Fetal Growth ◽

Gestational Age ◽

Fetal Growth Restriction ◽

Continuous Wave ◽

Small Sample ◽

Growth Restriction ◽

Low Risk ◽

Continuous Wave Doppler ◽

Prospective Longitudinal

Background Fetal growth restriction (FGR), defined as a fetus failing to reach its genetic growth potential, remains poorly diagnosed antenatally. This study aimed to assess the ability of continuous-wave Doppler ultrasound of the umbilical artery (CWD-UmA) to detect FGR in healthy women with low-risk pregnancies. Methods and findings This prospective longitudinal descriptive cohort study enrolled infants born to low-risk mothers who were screened with CWD-UmA between 28–34 weeks’ gestation; the resistance index (RI) was classified as normal or abnormal. Infants were assessed at 6, 10, 14 weeks, and 6 months postnatally for anthropometric indicators and body composition using the deuterium dilution method to assess fat-free mass (FFM). Neonates in the abnormal RI group were compared with those in the normal RI group, and neonates classified as small-for-gestational age (SGA) were compared with appropriate-for-gestational age (AGA) neonates. Eighty-one term infants were included. Only 6 of 26 infants (23.1%) with an abnormal RI value would have been classified as SGA. The abnormal RI group had significantly reduced mean FFM and FFM-for-age Z-scores at 6, 10, 14 weeks, and 6 months compared with the normal RI group (P<0.015). The SGA group’s FFM did not show this consistent trend when compared to AGA FFM, being significantly different only at 6 months (P = 0.039). The main limitation of the study was the small sample size of the infant follow-up. Conclusions Abnormal RI obtained from CWD-UmA is able to detect FGR and is considered a useful addition to classifying the neonate only by SGA or AGA at birth.

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Evaluation of the Effect of Low-Dose Aspirin on Biochemical and Biophysical Biomarkers for Placental Disease in Low-Risk Pregnancy: Secondary Analysis of a Multicenter RCT

American Journal of Perinatology ◽

10.1055/s-0038-1677476 ◽

2019 ◽

Vol 36 (13) ◽

pp. 1387-1393 ◽

Cited By ~ 2

Author(s):

Fionnuala Mone ◽

Cecilia Mulcahy ◽

Peter McParland ◽

Paul Downey ◽

Marie Culliton ◽

...

Keyword(s):

Blood Pressure ◽

Fetal Growth ◽

Low Dose ◽

Secondary Analysis ◽

Low Risk ◽

Dose Aspirin ◽

Risk Pregnancy ◽

Low Dose Aspirin ◽

Multicenter Rct ◽

Low Risk Pregnancy

Objective To assess the effect of aspirin use in low-risk pregnancy on: (1) pregnancy-associated plasma protein-A (PAPP-A) and placental-like growth factor (PLGF); (2) urinary albumin-to-creatinine ratio (ACR) and blood pressure; (3) fetal growth parameters; and (4) placental histopathology. Study Design This secondary analysis from the T rial of low-dose aspirin with an E arly S creening T est for preeclampsia and growth restriction randomized controlled trial was based on low-risk nulliparous women randomized at 11 weeks to (1) aspirin 75 mg; (2) no aspirin; and (3) aspirin based on the preeclampsia Fetal Medicine Foundation screening test. At baseline, women underwent assessment of blood pressure, PAPP-A, PLGF, and ACR, repeated 9 to 10 weeks postaspirin, in addition to fetal growth assessment. Gross and histopathological placental analyses were performed in line with Amsterdam criteria. Results A total of 445 subjects were included (aspirin n = 163 [36.6%]; no aspirin n = 282 [63.4%]). Although the fetal-to-placental weight ratio was significantly greater in the aspirin group (7.5 [±1.3] vs. 7.3 [±1.4], p = 0.045), as was change in ultrasound assessed estimated fetal weight from second to third trimesters (1,624.5 g [±235.1] vs. 1,606.2 [±189.4], p = 0.042), this was invalidated by the lack of a difference in birth weight. Aspirin did not significantly impact on change in serum or urine preeclampsia biomarkers, maternal blood pressure, or placental histopathology. Conclusion Aspirin use in low-risk pregnancy does not appear to impact on preeclampsia biomarkers, fetal growth, or placental pathology.

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