Elevated C-reactive protein levels during first trimester of pregnancy are indicative of preeclampsia and intrauterine growth restriction

AbstractIntroduction:Preeclampsia (PE) and intrauterine growth restriction (IUGR) are separate disease entities that have frequently been reported as sharing the same pathogenesis. In both of them, angiogenesis disorders and generalized endothelial damage with an accompanying inflammation are the dominant symptoms. In this study, we attempted to prove that both these processes demonstrate the same profile in early PE, late PE and IUGR patients, while the only difference is in the degree of exacerbation of the lesions.Patients, materials and methods:In 167 patients divided into four groups, three of those with early PE, late PE and IUGR and one control group, fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), high sensitive c-reactive protein (hsCRP) and fibronectin were determined. The behavior of these parameters in each of the groups was studied, and correlations between them were sought for.Results:Higher concentrations of sFlt-1, hsCRP and fibronectin and a lower concentration of PlGF were found in the study groups compared to the control group. Significant correlations were observed between the factors concerned.Conclusions:The higher values of disordered angiogenesis markers, endothelial damage markers and inflammatory markers both in the PE and the intrauterine growth restriction (IUGR) groups suggest the existence of shared disorders in the development of these pathologies. The correlations between disordered angiogenesis markers and endothelial damage markers argue in favor of a mutual relationship between these two processes in the development of pathologies evolving as secondary to placental ischemia. The results obtained confirm that the lesion profiles are the same in both PE and IUGR patients, which can be utilized in developing common diagnostic criteria.

Download Full-text

Correlation between Highly Sensitive C-Reactive Protein Level in Cases of Preeclampsia with or without Intrauterine-Growth Restriction

10.47275/0032-745x-s1-017 ◽

2020 ◽

Vol 106 (S1) ◽

Author(s):

Sadiq AM ◽

Hussein CM ◽

Mohammed RJ ◽

Yousif MG

Keyword(s):

Protein Level ◽

Intrauterine Growth Restriction ◽

Growth Restriction ◽

C Reactive Protein ◽

Intrauterine Growth ◽

Reactive Protein ◽

Highly Sensitive

Download Full-text

Determining diagnostic markers of intrautering growth retardation in early pregnancy

Reproductive health of woman ◽

10.30841/2708-8731.1.2021.229717 ◽

2021 ◽

Vol 1 ◽

pp. 61-65

Author(s):

Yu.P. Vdovichenko ◽

V.O. Golyanovskyi

Keyword(s):

Pregnant Women ◽

Mean Platelet Volume ◽

Intrauterine Growth Restriction ◽

First Trimester ◽

Growth Restriction ◽

Morbidity And Mortality ◽

Perinatal Morbidity ◽

Platelet Volume ◽

Intrauterine Growth ◽

First Trimester Of Pregnancy

Intrauterine growth restriction is the cause of significant increases in perinatal mortality, morbidity and problems in the development of newborns and infants. The leading place of this pathology is not accidental, because according to various authors, the frequency of perinatal loss associated with it is from 19 to 287‰ and more, the level of perinatal morbidity - from 58.7 to 88.0%.The objective: To determine certain serum and ultrasound markers during the first trimester of pregnancy and to improve the perinatal morbidity and mortality rate in women with intrauterine growth restriction. Materials and methods. A prospective study of pregnant women in the gestation period of 11 weeks 0 days – 13 weeks 6 days, which was to determine the level of plasma protein A associated with pregnancy (PAPP-A), mean platelet volume (MPV), and ultrasound placenta examination. Pregnant women were divided into 2 groups: the main group (n1-52) and the control group (n2-50). The study group consisted of women with a low PAPP-A level and changes in the mean platelet volume towards their increase. It is this group of women that is more sensitive, in our opinion, for the development of placental disorders and the occurrence of fetal growth retardation.Results. In this study, PAPP-А levels in 39 pregnant women were <0.5 MoM, and WTO levels in 36 cases were> 10 fl, which, according to the literature, can be used as markers of early prediction of ZRP.Ultrasound type of disorders of the first stage of trophoblast invasion is described as intra- and / or periplacental pathological areas, which can be considered the causes of placental insufficiency, which results in a risk of ZRP. According to the study, high specificity and sensitivity of Doppler parameters with the determination of indices (PI and IR) in the uterine arteries were established. Conclusions. The results of the study showed that performing a screening based on a detailed history and determining PAPP-A, MPV, and ultrasound examination at first trimester of pregnancy in women with the risk of IUGR allows for prophylactic treatment and monitoring of pregnancy and thus reduces neonatal morbidity and mortality.

Download Full-text

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.

Download Full-text

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

Download Full-text

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

Download Full-text

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.

Download Full-text