Second trimester Doppler ultrasound screening of the uterine arteries differentiates between subsequent normal and poor outcomes of hypertensive pregnancy: two different pathophysiological entities?

2004 ◽  
Vol 106 (4) ◽  
pp. 377-382 ◽  
Author(s):  
M. W. AARDEMA ◽  
M. C. S. SARO ◽  
M. LANDER ◽  
B. T. H. M. DE WOLF ◽  
H. OOSTERHOF ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnancy Outcome ◽  
Doppler Ultrasound ◽  
Early Onset ◽  
Uterine Artery ◽  
Normal Pregnancy ◽  
Striking Difference ◽  
Ultrasound Screening ◽  
Nulliparous Women ◽  
Poor Pregnancy Outcome

The ‘classical’ concept that pregnancy-induced hypertension (PIH) and pre-eclampsia (PE) primarily originate from defective placentation in early pregnancy has been challenged recently. There is growing evidence that other factors, including maternal predisposing conditions, also play a significant role in the pathophysiology of PIH and PE. The aim of the present study was to test the hypothesis that PIH and PE with an early onset and poor pregnancy outcome is associated with defective placentation, e.g. inadequate spiral artery dilatation and subsequent reduced uteroplacental perfusion, whereas PIH and PE with normal pregnancy outcome is not. Using Doppler ultrasound, we measured the uterine artery pulsatility index (PI) in a population of 531 nulliparous women in the 22nd week of gestation. Uterine artery PI was used as an index of resistance to blood flow in the uteroplacental circulation. Outcome measures were PIH/PE with or without poor pregnancy outcome, preterm birth and intra-uterine growth restriction (IUGR). The results revealed a striking difference between PI values for PIH/PE with and without poor pregnancy outcome. Uterine artery PI in the 22nd week was increased significantly in pregnancies which developed early-onset (before 35 weeks) PIH/PE with a poor pregnancy outcome. In contrast, uterine artery PI values were normal in women who developed PIH/PE, but had a good pregnancy outcome. There was a significant correlation between 22nd week uterine artery PI and subsequent preterm birth or IUGR. Our results indicate that only PIH/PE with poor pregnancy outcome is associated with defective placentation, whereas PIH/PE with good outcome is not. These findings support the concept of heterogeneous causes of hypertensive disorders of pregnancy.

DOPPLER ULTRASOUND SCREENING PREDICTS RECURRENCE OF POOR PREGNANCY OUTCOME IN SUBSEQUENT PREGNANCIES, BUT NOT THE RECURRENCE OF PIH OR PREECLAMPSIA

2000 ◽  
Vol 19 (3) ◽  
pp. 281-288 ◽  
Author(s):  
M. W. Aardema ◽  
M. Lander ◽  
H. Oosterhof ◽  
B. T. H. M. De Wolf ◽  
Jan G. Aarnoudse
Keyword(s):  
Pregnancy Outcome ◽  
Doppler Ultrasound ◽  
Ultrasound Screening ◽  
Poor Pregnancy Outcome

scholarly journals Prediction of preeclampsia using a combination of serum micro RNA-210 and uterine artery Doppler ultrasound

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110368
Author(s):  
Ananya Trongpisutsak ◽  
Vorapong Phupong
Keyword(s):  
Pregnant Women ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Early Onset ◽  
Uterine Artery ◽  
Micro Rna ◽  
Predictive Values ◽  
Uterine Artery Doppler ◽  
Early Onset Preeclampsia ◽  
Sensitivity Specificity

The objective was to determine whether a combination of serum micro RNA-210 level and uterine artery Doppler can predict preeclampsia in pregnant women at 16–24 weeks gestation. A prospective observational study conducted in singleton pregnant women at 16–24 weeks of gestation who had prenatal care at the King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand between 2017 and 2018. Uterine artery Doppler ultrasound and blood testing for serum micro RNA-210 were performed. Pregnancy outcomes were recorded. Optimal cut-off for uterine artery pulsatility index (PI) and serum micro RNA-210 were obtained to calculate the predictive values for preeclampsia. Data from 443 participants were analyzed. Twenty-two cases developed preeclampsia (5.0%) and seven of these preeclamptic cases had early-onset preeclampsia (1.6%). Pregnant women with preeclampsia had higher mean PI of the uterine artery (1.34 ± 0.52 vs 0.98 ± 0.28, p = 0.004), higher detection rates of diastolic notching (45.5% vs 11.2%, p < 0.001), and lower median serum micro RNA-210 level (22.86 vs 795.78, p < 0.001) than pregnant women without preeclampsia. Using abnormal serum micro RNA-210 level, abnormal mean PI or uterine artery diastolic notches to predict for preeclampsia, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 95.5%, 54.9%, 10.0%, and 99.6%, respectively. For early-onset preeclampsia prediction, the sensitivity, specificity, PPV, and NPV were 100.0%, 53.2%, 3.3%, and 100.0%, respectively. This study demonstrated that a combination of serum micro RNA-210 and uterine artery Doppler is effective in predicting preeclampsia in the second trimester.

OGO 6362 Uterine artery Doppler in the prediction of poor pregnancy outcome

1997 ◽  
Vol 23 ◽  
pp. S109
Author(s):  
H. Mun˜oz ◽  
S Leible ◽  
R vonMuhlembrock ◽  
C Díaz ◽  
J Jankelevich ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Uterine Artery ◽  
Uterine Artery Doppler ◽  
Poor Pregnancy Outcome

scholarly journals Lack of nitric oxide bioavailability in early pregnancy predisposes to dyslipidemia and surges preeclampsia and fetal growth retardation

2021 ◽  
Author(s):  
Aida A. Korish
Keyword(s):  
Nitric Oxide ◽  
Lipid Profile ◽  
Pregnancy Outcome ◽  
Normal Pregnancy ◽  
High Density Lipoproteins ◽  
No Production ◽  
Blood Lipid Profile ◽  
Pregnant Rats ◽  
Nitric Oxide Synthase Inhibitor ◽  
Poor Pregnancy Outcome

Background: Hyperlipidemia has been reported in preeclampsia (PrE) and is linked to poor pregnancy outcome and long-term cardiovascular complications. This study aimed to elucidate the relationship between nitric oxide (NO) and blood lipids levels during normal pregnancy and in NG-nitro-l-arginine methyl ester (L-NAME) - induced preeclampsia before and after magnesium sulphate (MgSO4) therapy and its effect on the pregnancy outcome.Methods: Forty female Wistar rats were divided into four groups: non pregnant (NP) group - non pregnant healthy rats receiving no treatment, control pregnant (Con-P) group - control pregnant rats receiving no treatment, pregnant (PE) group - pregnant animals with untreated PrE, and the pregnant MgSO4 (PE-Mg) group - pregnant animals with PrE- treated with MgSO4. The nitric oxide synthase inhibitor L-NAME was used to induce experimental model of PrE in the PE and the PE-Mg groups. The changes in total NO production, total cholesterol (TC), triglycerides (TG), low density lipoproteins (LDL-C), high density lipoproteins (HDL), LDL-C/HDL-C ratio, soluble vascular endothelial growth factor receptor-1 (sVEGFR1) also known as sFlt-1, blood pressure, kidney functions, body weight, and pregnancy outcome were assessed.Results: Decreased NO production in the PE group was associated with elevated TC, TG, LDL-C/HDL-C ratio, hypertension, proteinuria, increased urea, creatinine, and sFlt-1 levels, and poor pregnancy outcome demonstrated by high pup mortality rate and low birth weight. Increased NO production in the PE-Mg group treated with MgSO4 therapy was associated with decreased signs of preeclampsia and hypolipidemia and increased pup viability and birth weight.Conclusions: NO bioavailability is crucial for the homeostasis of the lipid profile in normal pregnancy and the prevention of preeclampsia. Routine periodic assessments of the blood lipid profile and the NO production in the pregnant females may be a helpful tool in early prediction of preeclampsia.

scholarly journals Ultrasonographic Signs of Poor Pregnancy Outcome

2017 ◽  
Vol 11 (1) ◽  
pp. 44-58
Author(s):  
Lucía Serrano-González ◽  
María Martinez-Moya ◽  
María Platero-Mihi ◽  
José Bajo-Arenas ◽  
Tirso Perez-Medina
Keyword(s):  
Pregnancy Outcome ◽  
Imaging Techniques ◽  
Three Dimensional ◽  
Normal Pregnancy ◽  
Abdominal Wall Defects ◽  
Crown Rump Length ◽  
Additional Information ◽  
Caudal Regression ◽  
3D Volume ◽  
Poor Pregnancy Outcome

ABSTRACT The frequency of spontaneous abortion, when it is considered from its very beginning, along with the theoretical knowledge of the causes of the abortion, should provide a perspective to the obstetrician that, performing a sonographic exploration finds discoveries that cannot correspond to those characterizing a normal pregnancy. The precocity of the realization of sonographic explorations in the pregnancy will allow diagnosis of many more cases of spontaneous interruptions of the development of pregnancy. New sonographic imaging techniques including three-dimensional (3D) sonography can provide additional information regarding the presence of structural anomalies via 3D volume acquisition, like craniofacial deformities, clefts, neural tube defects, abdominal wall defects, and caudal regression syndrome. It may give further details regarding the timing of embryonic/fetal demise in early pregnancy. Sufficient informational value is regularly obtained in cases having a crown-rump length >8 mm. How to cite this article Serrano-González L, Martinez-Moya M, Platero-Mihi M, Bajo-Arenas J, Perez-Medina T. Ultrasonographic Signs of Poor Pregnancy Outcome. Donald School J Ultrasound Obstet Gynecol 2017;11(1):44-58.

scholarly journals Effect of aspirin response signature gene expression on preterm birth and preeclampsia among women with lupus: a pilot study

Lupus ◽  
2019 ◽  
Vol 28 (14) ◽  
pp. 1640-1647
Author(s):  
A M Eudy ◽  
D Voora ◽  
R A Myers ◽  
M E B Clowse
Keyword(s):  
Gene Expression ◽  
Preterm Birth ◽  
Pilot Study ◽  
Pregnancy Outcome ◽  
Quantitative Polymerase Chain Reaction ◽  
Linear Regression Models ◽  
Global Test ◽  
Increased Risk ◽  
Poor Pregnancy Outcome

Background Women with lupus have an increased risk of preeclampsia and preterm birth, and aspirin 81 mg/day is recommended as a preventative measure for preeclampsia. This pilot study quantified the association between a 60-gene aspirin response signature (ARS) gene expression with preterm birth and preeclampsia risk among women with lupus taking aspirin. Methods The analysis included 48 RNA samples from 23 pregnancies in the Duke Autoimmunity Pregnancy Registry. RNA was isolated from peripheral blood, and quantitative polymerase chain reaction was performed for ARS genes. The primary outcome was poor pregnancy outcome (preeclampsia or preterm birth). Gene expression was modeled as a response to presence or absence of a poor pregnancy outcome using linear regression models, stratified by trimester. Results Of the 23 pregnancies, nine delivered preterm and four had preeclampsia. Expression of PBX1 and MMD was higher in the second trimester among patients who experienced a poor pregnancy outcome compared to those who did not. However, in a global test of all ARS genes, we identified no association between expression of ARS genes and poor pregnancy outcomes. Conclusion Our pilot study identified two candidate genes that are reflective of the platelet function response to aspirin. Further work is needed to determine the role of these genes in identifying women with lupus at high risk for preeclampsia and preterm delivery despite aspirin therapy.

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