The predictive value of the uterine artery pulsatility index during the early third trimester for the occurrence of adverse pregnancy outcomes depending on the maternal obesity

Background: Uterine artery Doppler waveform has been extensively studied as a predictive marker for the later development of preeclampsia and fetal growth restriction. Therefore, uterine artery doppler has emerged as a good test for the prediction of preeclampsia, being simple to perform, reproducible and non-invasive. The present study was done to evaluate the first trimester uterine artery Doppler in the prediction of adverse pregnancy outcome.Methods: This was a prospective cohort study for all pregnant women attending antenatal clinic during 11-14 weeks of gestation at Christian medical college and hospital, Ludhiana, during a period of 18 months. Study population of (n~270) was taken. A pre-designed case record was filled at the time of registration. After taking informed consent, these women underwent ultrasound for uterine artery Doppler pulsatility index along with nuchal translucency & nasal bone scan by transabdominal ultrasound. Patients were followed up throughout the gestation to find out the development of any adverse pregnancy outcomes (early onset preeclampsia, early onset fetal growth restriction, late onset preeclampsia, late onset fetal growth restriction, oligohydramnios, placental abruption and stillbirth).Results: In our study, about 75% of antenatal women were found to have normal first trimester uterine artery pulsatility index and the rest 25% had abnormal pulsatility index. About 40% of women with abnormal dopplers developed complications associated to hypertensive disorders and adverse pregnancy outcomes, while 60% went on to have a normal pregnancy. It was observed that 13.2% developed gestational hypertension, 10.29% developed pulmonary embolism, 1.47% developed eclampsia, 22.05% developed oligohydramnios, 42.64% developed fetal growth restriction, 4.41 % developed placental abruption and 5.88% delivered stillbirth neonates.Conclusions: As hypertensive disorders of pregnancy pose a great risk of maternal and fetal morbidity and mortality, an evolution of Doppler studies have proven to be beneficial. Doppler ultrasound was found to be a valuable modality in the evaluation of fetal and placental circulation as well as in the prediction of pregnancy outcomes. According to the receiver operating characteristic curve obtained in our study, sensitivity and specificity of first trimester uterine artery pulsatility index was predictive for pregnancy complications and adverse outcomes.

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Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2704-x ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Ying Dong ◽

Yanhong Zhai ◽

Jing Wang ◽

Yi Chen ◽

Xin Xie ◽

...

Keyword(s):

Gestational Age ◽

Pregnancy Outcomes ◽

Predictive Value ◽

Glycated Albumin ◽

Reference Intervals ◽

Adverse Pregnancy Outcomes ◽

Third Trimester ◽

The Third ◽

Adverse Pregnancy ◽

In Pregnancy

Abstract Background Many efforts have been focused on the alternative glycemic marker glycated albumin (GlyA) and its application in pregnancy during which profound physiological changes take place. Our objective was to determine the reference intervals (RIs) of GlyA in healthy Chinese pregnant women and to assess the predictive value of serum GlyA in adverse pregnancy outcomes. Methods Totally 421 healthy subjects including 137 in the first trimester, 152 in the second trimester, and 132 in the third trimester were enrolled from March to July 2019, for the purpose of establishing the trimester-specific RIs of GlyA. In addition, 67 pregnant women diagnosed with GDM were enrolled at 24–28 weeks of gestation. The diagnostic value of GlyA for GDM patients was evaluated and compared with that of fasting plasma glucose (FPG) at 24–28 weeks of gestation. The association between GlyA in the late pregnancy and the adverse pregnancy outcomes was analyzed with the data collected from January to June 2018 at our hospital. Results The estimated RIs of GlyA in present study were 11.26–15.10%, 10.04–13.50%, and 9.76–13.09% in the first, second, and third trimesters respectively. The areas under receiver operating characteristic (ROC) curves were 0.503 for GlyA and 0.705 for FPG. More importantly, the GlyA level in the third trimester was not more elevated in the patients with adverse pregnancy outcomes including large for gestational age (LGA), preterm delivery, hypertension and preeclampsia (PE). The exception was made with the GDM patients who suffered from postpartum hemorrhage and had significantly higher GlyA levels than the control group. Conclusions Our results showed that the GlyA was continuously decreased as the gestational age went up. The GlyA testing has limited value in diagnosing GDM and predicting adverse pregnancy outcomes.

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Combination of three‐dimensional placental vascular indices and volume and uterine artery pulsatility index at 10–13 weeks of gestation could improve the prediction of adverse pregnancy outcomes

Journal of Obstetrics and Gynaecology Research ◽

10.1111/jog.14781 ◽

2021 ◽

Author(s):

In Yang Park ◽

Jeong ha Wie ◽

Ji Hyun Park ◽

Ji Young Kwon

Keyword(s):

Pregnancy Outcomes ◽

Pulsatility Index ◽

Uterine Artery ◽

Three Dimensional ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

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Maternal obesity influences birth weight more than gestational diabetes

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03571-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Eman M Alfadhli

Keyword(s):

Birth Weight ◽

Gestational Diabetes ◽

Pregnancy Outcomes ◽

Maternal Obesity ◽

Reference Group ◽

Adverse Pregnancy Outcomes ◽

Antenatal Visit ◽

Oral Glucose ◽

The Mean ◽

Adverse Pregnancy

Abstract Background Maternal obesity and gestational diabetes (GDM) are commonly encountered during pregnancy. Both conditions are independently associated with unfavorable pregnancy consequences. The objective of this study was to compare the effects of obesity and GDM on birth weight, macrosomia, and other adverse pregnancy outcomes. Methods This cohort study involved 531 women with a singleton pregnancy attending the Maternity and Children’s Hospital, Medina, Saudi Arabia, between June 2014 and June 2015. Participants underwent a 75-g oral glucose tolerance test between 24 and 28 weeks. The International Association of Diabetes and Pregnancy Study Groups criteria were used for GDM diagnosis. BMI was assessed at the first antenatal visit, and obesity was defined as a BMI ≥30.0 kg/m2. All women were followed up until delivery. Women were divided into 4 groups: non-GDM nonobese (reference group), GDM nonobese, obese non-GDM, and obese GDM. Clinical characteristics and adverse pregnancy outcomes were compared. Results The mean age and BMI of the participants were 30.5 years and 29.3 kg/m2, respectively. GDM was diagnosed in 50.2% of the participants, and obesity was diagnosed in 47.8% of the participants. Obese women with GDM were the oldest and heaviest among all women. The mean birth weight increased in order among the four groups; it was highest in the infants in the obese GDM group, followed by those in the obese non-GDM, GDM nonobese and reference groups. Obesity and GDM alone or in combination were associated with higher rates of macrosomia and cesarean deliveries than the reference group. Neonatal intensive care unit (NICU) admission was higher in infants in the GDM nonobese and obese GDM groups. The frequency of low Apgar score was significantly higher in infants in the obese GDM group than in infants in the reference group. Conclusions Maternal obesity seems to influence birth weight more than GDM, while GDM is associated with a greater risk of admission to the NICU. The combination of both conditions is associated with the greatest risk of adverse pregnancy outcomes.

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