First trimester maternal serum analytes and second trimester uterine artery Doppler in the prediction of preeclampsia and fetal growth restriction

Uterine artery Doppler waveform analysis has been extensively studied in the second trimester of pregnancy as a predictive marker for the later development of preeclampsia and fetal growth restriction. The use of Doppler interrogation of this vessel in the first trimester has gained momentum in recent years. Various measurement techniques and impedance indices have been used to evaluate the relationship between uterine artery Doppler velocimetry and adverse pregnancy outcomes. Overall, first-trimester Doppler interrogation of the uterine artery performs better in the prediction of early-onset than late-onset preeclampsia. As an isolated marker of future disease, its sensitivity in predicting preeclampsia and fetal growth restriction in low risk pregnant women is moderate, at 40–70%. Multiparametric predictive models, combining first-trimester uterine artery pulsatility index with maternal characteristics and biochemical markers, can achieve a detection rate for early-onset preeclampsia of over 90%. The ideal combination of these tests and validation of them in various patient populations will be the focus of future research.

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Correlation between Parturients’ Uterine Artery Blood Flow Spectra in the First and Second Trimesters of Pregnancy and Fetal Growth Restriction

Journal of Healthcare Engineering ◽

10.1155/2021/2129201 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Hongna Yu ◽

Meiqin Yuan ◽

Ling Wang ◽

Xia Li ◽

Meiping Jiang

Keyword(s):

Blood Flow ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Uterine Artery ◽

First Trimester ◽

Growth Restriction ◽

Control Group ◽

Artery Blood Flow ◽

Second Trimester ◽

Total Incidence

Objective. To explore the correlation between parturients’ uterine artery blood flow spectra in the first and second trimesters of pregnancy and fetal growth restriction (FGR). Methods. The data of parturients treated in our hospital from February 2018 to February 2020 were retrospectively analyzed, 50 parturients with FGR were selected as the FGR group, and other 50 healthy cases were selected as the control group. In the first trimester (11-12 weeks of gestation) and the second trimester of pregnancy (13–24 weeks of gestation), the parturients of the two groups accepted the color Doppler ultrasonography (CDS), their hemodynamics indicators of uterine artery were recorded, and the correlation between their uterine artery blood flow spectra in the two periods and FGR was analyzed with the Receiver Operating Characteristic (ROC) curve. Results. No statistical differences in the parturients’ general information including age, gestational weeks, gravidity, and parity between the two groups were observed ( P > 0.05); the newborn’s body weight, Apgar scores, number of preterm infants, and the number of infants transferring to the neonatal intensive care unit (NICU) were significantly different between the two groups ( P < 0.05); in the first and second trimesters of pregnancy, the uterine artery pulsatility index (UtA-PI), uterine artery resistance index (UtA-RI), maximal systolic flow velocity, and systolic/diastolic (UtA-S/D) ratio were significantly higher in the FGR group than in the control group ( P < 0.05), and the time-averaged maximal velocity (TAMX) was significantly lower in the FGR group than in the control group ( P < 0.001); in early pregnancy, the incidence of early diastolic notch at bilateral uterine arteries between the two groups was not significantly different ( P > 0.05), and the unilateral and total incidence in the first trimester as well as the unilateral, bilateral, and total incidence in the second trimester were significantly higher in the FGR group than in the control group ( P < 0.05); in the first trimester, the sensitivity of detecting FGR with a uterine artery blood flow spectrum was 0.820, AUC (95% CI) = 0.840 (0.757–0.923), and in the second trimester, it was 0.860, AUC (95% CI) = 0.900 (0.832–0.968). Conclusion. There is a correlation between uterine artery blood flow spectra in the first and second trimesters of pregnancy and FGR, and the sensitivity of spectrum in the first trimester is higher than that in the second trimester, presenting a better clinical application value.

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First-trimester measurements of the three-dimensional ultrasound placental volume and uterine artery Doppler in early- and late-onset fetal growth restriction

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2018.1497601 ◽

2018 ◽

Vol 33 (4) ◽

pp. 564-569 ◽

Cited By ~ 2

Author(s):

Tatsuya Arakaki ◽

Junichi Hasegawa ◽

Masamitsu Nakamura ◽

Hiroko Takita ◽

Shoko Hamada ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Uterine Artery ◽

Late Onset ◽

Three Dimensional ◽

First Trimester ◽

Growth Restriction ◽

Uterine Artery Doppler ◽

Placental Volume

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First trimester uterine artery Doppler screening in the prediction of adverse pregnancy outcomes

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20213864 ◽

2021 ◽

Vol 10 (10) ◽

pp. 3933

Author(s):

Jacqueline A. Jayson ◽

Kavita Mandrelle ◽

Tapasya Dhar ◽

Subhash Singla

Keyword(s):

Fetal Growth ◽

Pregnancy Outcomes ◽

Fetal Growth Restriction ◽

Pulsatility Index ◽

Uterine Artery ◽

First Trimester ◽

Adverse Pregnancy Outcomes ◽

Growth Restriction ◽

Uterine Artery Doppler ◽

Adverse Pregnancy

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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