Prospective observational study to determine the accuracy of first-trimester serum biomarkers and uterine artery Dopplers in combination with maternal characteristics and arteriography for the prediction of women at risk of preeclampsia and other adverse pregnancy outcomes

Abstract Background Low birthweight (LBW) is associated with higher mortality and morbidity, but there is limited data on the prevalence of LBW in rural Africa, where many births occur at home. The Bacillus Calmette-Guérin (BCG) vaccine has non-specific effects. Studies suggest that maternal BCG-vaccination may affect the health of the child. Methods The present study is nested within a randomised trial in rural Guinea-Bissau: Pregnancies were registered at two-monthly village visits, where information on BCG scar status and other background factors were obtained. Children were enrolled in the trial and weighed at home within 72 h after birth. In this prospective observational study, we assessed factors associated with adverse pregnancy outcomes and birthweight in binomial and linear regression models. Results Among 1320 women who had their BCG scar status assessed, 848 (64%) had a scar, 472 (36%) had no scar. The risk of adverse pregnancy outcomes (miscarriages, stillbirths, early neonatal deaths) tended to be higher among BCG scar-negative women (13%) than among women with a BCG scar (10%), adjusted prevalence ratio = 1.29 (0.99–1.68). Birthweight was assessed for 628 (50%) of the 1232 live born children. The mean birthweight was 2.89 kg (SD 0.43) and the proportion of LBW children was 17% (104/628). Sex, twinning, region of birth, maternal age, maternal mid-upper arm circumference (MUAC), antenatal consultations, parity and possession of a mobile phone were associated with birthweight, while maternal BCG scar status was not. Conclusions This study provides the first birthweight data for home-born children in rural Guinea-Bissau, with a mean birthweight of 2.89 kg (SD 0.43) and a LBW prevalence of 17%. We found a tendency for higher risk of adverse pregnancy outcomes among BCG scar-negative women. Birthweight was similar in children of mothers with and without BCG scar.

Download Full-text

Association of low levels of first trimester Pregnancy Associated Plasma Protein (PAPP-A) with adverse pregnancy outcomes: An observational study

Obstetrics and Gynecology Reports ◽

10.15761/ogr.1000116 ◽

2017 ◽

Vol 1 (3) ◽

Cited By ~ 1

Author(s):

Archana Ranganathan ◽

John Fresen ◽

Pampa Sarkar

Keyword(s):

Observational Study ◽

Plasma Protein ◽

Pregnancy Outcomes ◽

First Trimester ◽

Adverse Pregnancy Outcomes ◽

First Trimester Pregnancy ◽

Trimester Pregnancy ◽

Low Levels ◽

Adverse Pregnancy

Download Full-text

Uterine artery Doppler in first trimester in prediction of adverse pregnancy outcome in Dharmapuri district of Tamil Nadu

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204008 ◽

2020 ◽

Vol 9 (10) ◽

pp. 4268

Author(s):

Bindu S.

Keyword(s):

Pregnancy Outcomes ◽

Uterine Artery ◽

Gestational Hypertension ◽

First Trimester ◽

Adverse Pregnancy Outcomes ◽

Case Group ◽

Uterine Artery Doppler ◽

Hypertensive Disorders ◽

Group 5 ◽

Adverse Pregnancy

Background: Pregnancies are complicated by hypertensive disorders of about 5-10% and hemorrhage, sepsis, and fetal growth restriction constitute a triad contributing to maternal morbidity and mortality. Hypertensive disorders in pregnancy vary from mildly elevated blood pressure to severe hypertension with multi-organ dysfunction. The study aims to evaluate the first-trimester uterine artery Doppler in the prediction of the development of adverse pregnancy outcomes.Methods: This prospective longitudinal observational was done in Dharmapuri Medical College and Hospital were selected for this study. Totally 150 pregnant women were included in the study. 75 were controls and 75 cases. The study period was from June 2018 to February 2019. Evaluating the optimal definition of abnormal first trimester.Results: Previous obstetric history in the study population. In the study group 3% of bad obstetric history (BOH) present. In the case group, 5% has BOH due to 2 neonatal death and 2 term intrauterine device (IUD), uterine artery Doppler parameters to predict adverse pregnancy outcomes, and association of gestational hypertension in the study groups. In the control group, 1%, and the case group 5% of them had gestational hypertension. Out of 4, 3 had an average uterine artery Doppler more than 2.3 (maximum of 2.7) and 1 had single uterine artery Doppler abnormality.Conclusions: The study showed that first-trimester uterine artery Doppler with single and average uterine artery pulsatility index (PI) >95th centile (2.3) has a better screening value in my population. The overall performance of the first-trimester uterine artery Doppler in the prediction of adverse pregnancy outcomes is valuable.

Download Full-text

Second trimester umbilical artery Doppler in the prediction of adverse pregnancy outcomes in a low risk population: A prospective observational study

International Journal of Clinical Obstetrics and Gynaecology ◽

10.33545/gynae.2020.v4.i6c.750 ◽

2020 ◽

Vol 4 (6) ◽

pp. 167-173

Author(s):

Adeyemi Sunday Adefisan ◽

Akinyemi Akinsoji Akintayo ◽

Jacob Olumuyiwa Awoleke ◽

Anthony Awolowo Thomas ◽

Olusola Peter Aduloju ◽

...

Keyword(s):

Observational Study ◽

Pregnancy Outcomes ◽

Prospective Observational Study ◽

Umbilical Artery ◽

Adverse Pregnancy Outcomes ◽

Low Risk ◽

Second Trimester ◽

Risk Population ◽

Umbilical Artery Doppler ◽

Adverse Pregnancy

Download Full-text

Notching and Pulsatility Index of the Uterine Arteries and Preeclampsia in Twin Pregnancies

Journal of Clinical Medicine ◽

10.3390/jcm9082653 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2653

Author(s):

Stephanie Springer ◽

Mariella Polterauer ◽

Maria Stammler-Safar ◽

Harald Zeisler ◽

Heinz Leipold ◽

...

Keyword(s):

Pregnancy Outcomes ◽

Pulsatility Index ◽

Uterine Artery ◽

Uterine Artery Doppler ◽

Uterine Arteries ◽

Increased Risk ◽

Adverse Pregnancy ◽

Doppler Indices ◽

Twin Pregnancies ◽

Risk Of Preeclampsia

Increased uterine artery Doppler indices have been shown to be associated with preeclampsia and adverse pregnancy outcomes in singleton and twin pregnancies. At 20–22 weeks of gestation, we assessed the use of notching, the highest, lowest, and mean pulsatility index (PI), and the combination of notching and PI of the uterine arteries to screen for preeclampsia. This was done in a cohort of 380 twin pregnancies. The results showed that the combination of notching and the highest PI above the 95th centile of the uterine arteries gives the best screening characteristics for preeclampsia in twin pregnancies. We calculated sensitivities for preeclampsia for notching, highest PI, and the combination of notching and the highest PI of 50%, 45% and 91%, with specificities of 96%, 96% and 93%, respectively. The present findings demonstrate that notching, increased highest PI, and the combination of notching and the highest PI of the uterine arteries is associated with an increased risk of preeclampsia in twin pregnancies. We observed the highest sensitivity and specificity by using the combination of notching and the highest PI of the uterine arteries.

Download Full-text

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.

Download Full-text