scholarly journals Hemodynamical parameters in functional system "motherplacenta-fetus" in women had higher levels of alpha-fetoprotein (AFP) and horionic gonadotropin (HG) in 11 trimester of pregnancy

2021 ◽  
Vol 51 (4) ◽  
pp. 22-26
Author(s):  
A. V. Gagarina ◽  
N. G. Pavlova ◽  
T. K. Kaicheeva
Keyword(s):  
Uterine Artery ◽  
Umbilical Artery ◽  
Resistance Index ◽  
Functional System ◽  
Maternal Serum ◽  
Alpha Fetoprotein ◽  
Control Group ◽  
Uterine Arteries

Haemodinamic parameters in the functional system mother-placenta-fetus in 49 women with elevated mildtrimester maternal serum AFP (2MoM) and in 38 women with elevated maternal serum hCG (2MoM) were studed. The control group included 32 women with normal mildtnmester serum AFP and hCG. Indexes of impedance to flow in the uterine arteries were significantly higher in patients with elevated MSAFP or MShCG comparing with women of the control group, beginning from 28 weeks of pregnancy. There was a significant association between the maternal serum AFP levels and indexes of impedance to flow in the uterine artery, umbilical artery and fetal aorta during pregnancy. In patients with abnormal (more then 95th centile) uterine arteries Resistance Index at 2024 weeks, abnormal dynamic of MSAFP and MShCC levels from 16 until 24 weeks was observed. We suppose that unexplained elevated mildtri mester maternal serum AFP and hCC сaп be associated with disturbed utero-placental circulation.

Features of hemodynamics of the mother–placenta–fetus system in the first half of pregnancy after the assisted reproductive technologies application

2018 ◽  
pp. 62-66
Author(s):  
L.M. Vygivska ◽  
◽  
I.V. Maidannyk ◽  
O.O. Chorna ◽  
V.F. Oleshko ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Doppler Ultrasound ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Control Group ◽  
Uterine Arteries ◽  
The Right

Doppler study is one of the main methods for assessing the condition of placental blood circulation and fetal hemodynamics. Doppler blood flow in the uterine arteries demonstrates the broad capabilities of the method for predicting pregnancy complications such as gestosis, fetal development delay, preterm birth, as well as for diagnosing adverse perinatal consequences. However, there is still no clear opinion about the feasibility of using Doppler as a screening test, as well as about the optimal pregnancy period for this type of study. The objective: is to study the hemodynamic features in pregnant women after assisted reproductive technologies (ART) application in the dynamics of the first part of pregnancy. Materials and methods. 299 pregnant women were examined – the main group included 249 women whose pregnancy occurred as a result of ART application. The control group consisted of 50 pregnant women with spontaneous pregnancy and its physiological course. I group – 94 women with tubal-peritoneal factor of infertility, II group – 87 women with endocrine factor of infertility, III group - 68 women whose infertility was caused by the male factor. Doppler ultrasound examination of the uterine arteries, arteries of the umbilical cord and middle cerebral arteries of the fetus were conducted. Results. It was found that the highest intensity of hemodynamics in the uterine artery basin at 11–12 weeks of gestation was recorded in a group of patients with a physiological course of pregnancy. The systolic-diastolic ratio in the right and left uterine arteries in these patients was 1.9 (1.8–2.7) and 2.1 (1.9–2.6), respectively. In contrast to women in the control group, pregnant women after ART application analyzed indicators were higher (1.6–1.9 times; p<0.0001). The systolic-diastolic ratio in the right uterine artery in III group was 3.0 (2.4–3.5), I group – 3.3 (3.1–3.4). Similar data were obtained analyzing the curves of blood flow rates in the left uterine artery – 2.9 (2.1–3.5) and 3.0 (2.7–3.6), respectively. The highest peripheral resistance, both in the right (3.6 (3.4–3.7) and left (3.5 (3.2–3.8) uterine arteries, was naturally registered in pregnant women of II group. In 36 (72%) patients with uncomplicated course and successful gestation at 11–12 weeks of pregnancy, blood flow was not recorded in the intervellon space. In the vast majority – 50 (73.5%) pregnant women of I group, two types of blood flow were registered in the intervellar space: pulsating arterial and continuous venous. Only in 18 (26.5%) patients of this group the blood flow in intervellon space was not determined. As a result of the obtained data analysis, it was found that at 16-17 weeks of gestation, the highest intensity of blood flow in the uterine artery pool was recorded in the control group. Thus, the systolic-diastolic ratio of the right and left uterine arteries in these subjects was 1.6 (1.5–1.8) and 1.8 (1.6–2.0). In pregnant women of the main group, the indicators were significantly higher (1.2-2.0 times; p<0.0001). The systolic-diastolic ratio in the uterine arteries in group III was 2,1 (1,9–2,6); 2,2 (1,9–2,5), in the II group – 3,1 (2,5–3,3); 2,2 (1,9–2,5), in the I group – 2,6 (2,5–3,2); 2,7 (2,5–2,9). In contrast to the control group, in which the systolic-diastolic ratio in the fetal umbilical artery was 3.4 (3.3–3.5), in III group patients, there was a significantly higher intensity of umbilical blood flow (S/D – 3.3 (3.5–3.6), p=0.03). At the same time, feto-placental hemodynamics in II and I groups patients was characterized by a significant increase in the numerical values of blood flow in the umbilical arteries (S/D – 4.5 (4.4–4.7), p=0.0001 and 3.5 (3.5–3.6), p=0.03, respectively). In patients of the control group, the systolic-diastolic ratio of the middle cerebral artery of the fetus at 16–17 weeks of gestation was 3.4 (3.4–3.5), almost completely coinciding with the same indicator in the umbilical artery (S/D – 3.4 (3.3–3.5). Patients of group III had a higher blood flow intensity, as evidenced by significantly lower (S/D 3.2 (3.1–3.3), compared with the control group (S/D 3.4 (3.4–3.5) absolute values of the systolic-diastolic ratio. An increase in the intensity of blood flow in the fetal medial artery (against the background of increased vascular resistance in the umbilical artery) was also recorded in the group of subjects of group II (S/D – 2.8 (2.7–2.9). High absolute values of systolic-diastolic ratio in the indicated vessel (4.4 (4.3–4.5) were found in the fetuses of the examined group and group, which characterize a significant decrease in the intensity of cerebral blood flow, compared with all the analyzed groups. Conclusions. Thus, the results of the study allow us to attribute Doppler ultrasound to highly informative research methods that make it possible to predict hemodynamic changes in the mother-placenta-fetus system, depending on the type of infertility, take preventive measures and start correction in time. Keywords: pregnancy, assisted reproductive technologies, Doppler ultrasound, uterine arteries, systolic-diastolic ratio.

Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  
Keyword(s):  
Pregnant Women ◽  
Resistance Index ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Premature Delivery ◽  
Control Group ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Placental Blood ◽  
Two Stages

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

scholarly journals THE EFFECT OF RECTAL PROGESTERONE ON DOPPLER PARAMETERS OF THE UTERINE ARTERIES FOR THE PREVENTION OF PRETERM DELIVERY IN IRAQI POPULATION

2018 ◽  
Vol 11 (10) ◽  
pp. 545
Author(s):  
Fatin Shallal Farhan ◽  
Ban Hadi Hameed ◽  
Muna Abdulghani Zghair
Keyword(s):  
Pregnant Women ◽  
Preterm Labor ◽  
Resistance Index ◽  
Control Group ◽  
Study Group ◽  
Duration Of Treatment ◽  
Uterine Arteries ◽  
Doppler Study ◽  
Threatened Preterm Labor ◽  
Doppler Indices

Objective: The effectiveness of progesterone in the prevention of threatened preterm labor has been established for many years, but the preferable route, dose, and duration of treatment are until now under the evaluation of researches. The aim of this study was to determine the effect of rectal progesterone on Doppler indices of the uterine arteries in pregnant women with threatened preterm delivery.Methods: A prospective case–control study was conducted at the obstetric ward and the Outpatients Department of Al-Yarmouk Teaching Hospital in Baghdad for the period of 1 year from April 1, 2017, to April 1, 2018. 100 women were enrolled in the study, 50 of them were pregnant women with a diagnosis of preterm labor assigned as a study group and the other 50 were apparently healthy pregnant women of the same gestational age assigned as a control group. Doppler study of uterine arteries was done to all participants, and the results were compared for both groups. The patients with preterm labor received nifedipine tocolysis initially until contractions subsided and Doppler study had been repeated for those women after 1 week of rectal progesterone therapy.Results: The study group had a significantly higher resistance index (RI) than the control group (0.58 vs. 0.52) as p<0.05, in spite of the pulsatility index (PI) being higher for the study group compared to the control group (0.78 vs. 0.77) but this difference was not statistically significant. The RI before the therapy (0.58) was significantly higher than the index after therapy (0.52), and the PI was again significantly higher before therapy (0.78) than after therapy (0.71) as p<0.05. During the follow-up period, 3 (6.5%), 4 (8.7), and 39 (84.8%) patients delivered within 1 week, after 1 week, and at term, respectively.Conclusion: Rectal progesterone can arrest threatened preterm labor, and this effect is possible in part explained by its action on uterine arteries.

scholarly journals Study of Maternal and Fetal Doppler Velocimetry, Histopathology of Placental Bed in Diabetic Pregnancy and Its Correlation to Fetal Outcome

2021 ◽  
Vol 4 (3) ◽  
pp. 01-10
Author(s):  
Emadeldin Matar
Keyword(s):  
Diabetes Mellitus ◽  
Umbilical Artery ◽  
Diabetic Group ◽  
Waveform Analysis ◽  
Control Group ◽  
Control Groups ◽  
Uterine Arteries ◽  
Significant Difference ◽  
The Mean ◽  
Doppler Indices

Diabetes mellitus still represents an important medical problem during pregnancy, causing perinatal morbidity and mortality. Despite improved outcome reflected by a steep decline in perinatal mortality over the past few decades, controversy still exists regarding the care of the pregnant woman with both pre-existing and gestational Diabetes Mellitus. Doppler ultrasound is especially valuable during pregnancy because fetal maternal and placental circulations can be studied. The aim of this work was to study the vascular changes in the uteroplacental and fetoplacental circulations, and to correlate these findings with histopathology of the placenta and placental bed, which may occur in association with diabetic pregnancies. The study was carried out on 100 pregnant women of comparable age and parity. They were divided into 2 groups. The control group comprising 20 normal non-diabetic pregnant women and the normotensive diabetic group comprising 80 pregnant diabetic women. All were singleton pregnancies of 34 weeks or more and were delivered by C.S the control and the study cases were subjected to history taking and thorough physical examination. They were also subjected to ultrasonographic examination for fetal biometric parameters and for Doppler examination. Doppler examination included umbilical artery, uterine arteries fetal middle cerebral artery. At the time of C.S the placenta and placental bed biopsy was obtained. After delivery, the Apgar score of the newborn was assessed at 1 and 5 minutes, the body weight was measured, and the fetus was followed up for any complications. Result: There was a positive correlation between the umbilical artery PI and the mean blood glucose levels indicating that poor diabetic control is probably associated with increased umbilical artery PI. However, there was no significant difference between the mean value of the umbilical artery PI in the diabetic and control groups. The uterine arteries Doppler indices showed no significant findings between the diabetic and the control groups. Neither did the uterine arteries Doppler indices show a correlation with the mean blood glucose levels. There was no significant difference between the middle cerebral artery PI in the diabetic and control groups. This observation indicates that there was no redistribution in the fetal circulation in the fetuses of the diabetic group. There was also non correlation between the MCA Doppler indices and the glycemic control. Histopathologic studies of the placental bed showed marked difference between the diabetic group and the control group as regards lack of physiologic changes and arteriosclerotic changes, which emphasizes the effect of diabetes on the placental bed vasculature. Conclusion: Abnormal umbilical artery waveform analysis is one of significant predictors of fetal compromise in diabetic pregnancy, but fetal compromise can occur in association with normal Doppler waveform analysis. In maternal diabetes the classic redistribution seen in fetal hypoxemia due to uteroplacental insufficiency may not occur in diabetic patient even in severely compromised fetuses. In maternal diabetes mellitus, maternal glycemic control has no effect on impedance to flow in the uterine and middle cerebral arteries. No relationship was found between the uterine or umbilical arteries Doppler indices and the placental bed decidual vascular pathology in diabetic pregnancies. There was no correlation between placental findings and the Doppler waveform analysis of the umbilical and the uterine arteries.

The Effect of Antenatal Vaginal Progesterone Administration on Uterine, Umbilical, and Fetal Middle Cerebral Artery Doppler Flow: A Cohort Study

2019 ◽  
Vol 37 (05) ◽  
pp. 491-496
Author(s):  
Ahmed M. Maged ◽  
Amira Y. Shoab ◽  
Eman A. Hussein ◽  
Ahmed H. Alsawaf ◽  
Doaa S. Mahmoud ◽  
...  
Keyword(s):  
Cohort Study ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Resistance Index ◽  
Doppler Measurement ◽  
Vaginal Progesterone ◽  
Before And After ◽  
Doppler Indices

Abstract Objective This study aimed to evaluate the effect of vaginal progesterone (P) administration during the second and third trimesters of pregnancy on Doppler velocimetry of uterine, umbilical, and middle cerebral vessels. Study Design A prospective cohort study conducted on 80 women at risk for preterm labor. Uterine artery, umbilical artery, and middle cerebral artery (MCA) Doppler indices were measured before and after 1 week of administration of 200 mg twice daily vaginal P. The primary outcome parameter was the change of MCA pulsatility index (PI) after P administration. Secondary outcomes included changes in uterine artery and umbilical artery Doppler measurement. Results There was no significant changes of umbilical artery resistance index (RI) (0.69 ± 0.049 vs. 0.68 ± 0.041), umbilical artery PI (1.14 ± 0.118 vs. 1.11 ± 0.116), uterine artery RI (0.66 ± 0.12 vs. 0.66 ± 0.107), uterine artery PI (1.00 ± 0.26 vs. 1.016 ± 0.24), and MCA PI (1.27 ± 0.18 vs. 1.26 ± 0.23) measurements before and after 1 week of P administration, respectively. Conclusion Administration of vaginal P has no significant effects on uterine artery, umbilical artery, and MCA Doppler indices.

scholarly journals Effects of Yoga on Utero-Fetal-Placental Circulation in High-Risk Pregnancy: A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Abbas Rakhshani ◽  
Raghuram Nagarathna ◽  
Rita Mhaskar ◽  
Arun Mhaskar ◽  
Annamma Thomas ◽  
...  
Keyword(s):  
High Risk ◽  
Standard Care ◽  
Uterine Artery ◽  
Controlled Trial ◽  
Resistance Index ◽  
High Risk Pregnancy ◽  
Trophoblast Invasion ◽  
Control Group ◽  
Risk Pregnancy ◽  
Yoga Group

Introduction. Impaired placentation and inadequate trophoblast invasion have been associated with the etiology of many pregnancy complications and have been correlated with the first trimester uterine artery resistance. Previous studies have shown the benefits of yoga in improving pregnancy outcomes and those of yogic visualization in revitalizing the human tissues.Methods. 59 high-risk pregnant women were randomized into yoga (n= 27) and control (n= 32) groups. The yoga group received standard care plus yoga sessions (1 hour/day, 3 times/week), from 12th to 28th week of gestation. The control group received standard care plus conventional antenatal exercises (walking). Measurements were assessed at 12th, 20th, and 28th weeks of gestation.Results. RM-ANOVA showed significantly higher values in the yoga group (28th week) for biparietal diameter (P= 0.001), head circumference (P= 0.002), femur length (P= 0.005), and estimated fetal weight (P= 0.019). The resistance index in the right uterine artery (P= 0.01), umbilical artery (P= 0.011), and fetal middle cerebral artery (P= 0.048) showed significantly lower impedance in the yoga group.Conclusion. The results of this first randomized study of yoga in high-risk pregnancy suggest that guided yogic practices and visualization can improve the intrauterine fetal growth and the utero-fetal-placental circulation.

scholarly journals Effect of Antioxidants on the Occurrence of Pre-eclampsia in Women at Increased Risk

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Mahmoud. A. Sultan - Hassan Salim - Y. Elmesallawy - E.A.Elt
Keyword(s):  
High Risk ◽  
Gestational Age ◽  
Uterine Artery ◽  
Resistance Index ◽  
Secondary Outcome ◽  
Control Group ◽  
High Risk Population ◽  
Elevated Liver Enzymes ◽  
Increased Risk ◽  
Pai 1

The objective of this work is: Asses the potential benefit of antioxidant supplementation on the occurrence of preeclampsia at high risk women. Patients and Methods: The number of primigravida women's collected was " 294" with gestational age ranged from 18-22 wks. .from (294) prim gravida cases ,(25) women were identified as being at increased risk of pre-eclampsia by abnormal Doppler wave form in either uterine artery at 18-22 weeks' gestation ( defined as a resistance index < 95th centile for gestation or the presence of an early diastolic notch ) , Another (25) women with history in the preceding pregnancy of pre-eclampsia, eclampsia or HELLP (Hemolysis, elevated liver enzymes, low platelets ) . -Total number of eligible participants were, (50) cases. Design and procedure: Cases divided randomly into two groups each 25 cases one group received tablets of 1000 mg vitamin C, (Cevitil efferecent. EPICO) + 400 iu of vitamin E (E-Viton 400 pharco). Venous blood for measurement of PAI-1 and PAI-2, The primary outcome measure was the ratio PAI-1 / PAI-2 and the secondary outcome prospectively according to guidelines of international society for the study of hypertension in pregnancy. Results: Doppler screening was done on, 294 prim gravidae with gestational age ranged from 18-22 weeks; only 42 women showed abnormal Doppler study so asked to come for rescanning at 24 weeks' gestation. 31 out of 42 patients (75%) have persistent abnormal study. The remainders of the 42 women (25%) were withdrawn from the study at 24 wks.' gestation because they have normal uterine-artery scan. Development of mild preeclampsia was statistically lower (p<0.5) in the study than that in the control group. However, development of sever preeclampsia or superimposed preeclampsia was statistically insignificant between both groups. PAI-1 was significantly increased in women developed preeclampsia more than normotensive (167±71.2, 113.8±35.6ng/ml respectively) with P=0.03 IN contrast PAI-2 was significantly decreased in women developed preeclampsia less than normotensive (105±34.9, 181.1±67.9ng/ml respectively) with P=0.018. Conclusion: Treatment and prevention trials of preeclampsia have been disappointing to date. However, this study has suggested causal links between oxidative stress and the development of preeclampsia indicate that may be a role for antioxidant vitamins in the prevention of preeclampsia. a high- risk population can be successfully identified on the basis of uterine-artery Doppler screening and pervious history of the disease.

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