scholarly journals Serum Beta HCG and uterine artery Doppler studies in second trimester to predict preeclampsia and eclampsia

Author(s):  
Nitin Kulkarni ◽  
Radhika Bansal ◽  
Pankaj Pawar

Background: Hypertensive disorders during pregnancy remain amongst the most significant and intriguing unsolved problems in obstetrics. The study aims at testing the hypothesis that women with high serum beta hCG levels and alterations in waveforms in the uterine artery doppler in early second trimester have high risk of developing pre-eclampsia.Methods: Serum Beta hCG estimation was done by Sandwich chemiluminescence immunoassay method. All uterine artery waveforms were obtained using a Toshiba nemio ultrasound machine attached to a 3.5 MHz curvilinear transducer, with colour and pulsed Doppler abilities.Results: For prediction of preeclampsia or eclampsia uterine artery Doppler velocimetry alone shows specificity of 96.30%, sensitivity of 90%, positive predictive value of 94% and negative predictive value of 80%. When it is combined with serum beta HCG sensitivity and specificity are almost same, but alone serum beta HCG levels are showing sensitivity of 96% and specificity of just 76%.Conclusions: Abnormal waveforms on uterine Doppler studies are the better predictors for preeclampsia and eclampsia when done in early second trimester.

Author(s):  
Pradip R. Gaikwad ◽  
Manisha R. Gandhewar ◽  
Nity Rose ◽  
Vidyadhar Suryakar

Background: Pregnancy induced hypertension (PIH) is associated with adverse perinatal outcome. Multi vessel color Doppler studies are useful in these cases for timely intervention. The aim of present study was to know the significance of umbilical, middle cerebral and uterine artery Doppler studies in PIH and to analyse its role in predicting perinatal outcome.Methods: This was a prospective study of 106 singleton pregnancies in the third trimester with PIH. The results of last Doppler ultrasound within one week of delivery were used for analysis. Adverse perinatal outcome was studied in the form of emergency cesarean section for fetal distress, meconium stained amniotic fluid, Apgar at 5 min <7, NICU admission and perinatal mortality (stillbirths and neonatal death). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of various Doppler parameters were calculated after comparing with standard.Results: In the present study specificity and diagnostic accuracy of all Doppler ultrasound parameters was high in predicting adverse perinatal outcome. Cerebroplacental ratio showed highest specificity (98.55%), PPV (94.44%) and diagnostic accuracy (80.19%) in predicting adverse perinatal outcome and it is better than MCA PI and UA PI alone. Uterine artery Doppler evaluation also gives additional information in predicting adverse perinatal outcome.Conclusions: Amongst various Doppler parameters cerebroplacental index (MCA/UA PI) is best predictor of adverse perinatal outcome.


Author(s):  
Vishal S. Sheth ◽  
Kanaklata D. Nakum ◽  
Mehul D. Patel ◽  
Mayank R. Lunagariya

Background: PIH, a pregnancy-specific disorder, is one of the major causes of maternal and perinatal morbidity and mortality worldwide.PIH and fetal growth restriction are important causes of perinatal and maternal morbidity and mortility.Methods: Hundred Indian pregnant women in their second trimester (13-20 weeks) and in their late second trimester (24-28 weeks) investigated for their serum β-hCG level and uterine artery Doppler studies respectively, attending OPD/IPD in Sir T. hospital, Bhavnagar from June 2014 to June 2015.Results: There is no clinical significance between parity and occurrence of PIH (p=0.2) and FGR (p=0.7). Out of 77 patients with their β hCG level ≤2 MoM, 2 patients (2.59%) developed PIH and FGR. And from 12 patients with their β hCG level ≥2 MoM 10 patients (80%) developed PIH and FGR which is highly significant (p<0.001). The study establishes the validity of beta HCG as a predictor of PIH and FGR with the sensitivity of 83.3%, specificity of 97.5%.Conclusions: This study can be concluded by there is a strong association between high maternal serum ß-hCG level, abnormal uterine Doppler studies with predicting adverse outcome of pregnancy like PIH and FGR. There is also a good association between high maternal serum ß-hCG level and rising severity of the disease.


2021 ◽  
Vol 224 (2) ◽  
pp. S397-S398
Author(s):  
Eliza C. Miller ◽  
Benjamin Carper ◽  
Natalie Bello ◽  
Noel Bairey Merz ◽  
Philip Greenland ◽  
...  

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110368
Author(s):  
Ananya Trongpisutsak ◽  
Vorapong Phupong

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.


Author(s):  
Ritu Mishra ◽  
Aditya P. Misra

Background: Pregnancy induced hypertension (PIH) is associated with adverse perinatal outcome. Multi vessel colour Doppler studies are useful in these cases for timely intervention. The aim of present study was to know the significance of umbilical, middle cerebral and uterine artery Doppler in PIH and to analyse their role in predicting perinatal outcome.Methods: This is a study of 150 pregnant women with pregnancy induced hypertension (PIH). These patients were evaluated with colour Doppler and were followed subsequently for any adverse perinatal outcome.Results: Out of 150 cases 70% of cases were found in 20-30 years age group. 98 cases had abnormal uterine artery Doppler indices accounting for 65.3%, while 52 cases had a normal Doppler index accounting for 34.3%. Out of 150 cases, 94 (64.6%) cases had abnormal middle cerebral artery. In our study 53 cases had abnormal umbilical artery Doppler indices accounting for 35.4%, while 97 cases had a normal Doppler index accounting for 64.6%. Out of 150 cases in our study 27 cases had Reversal of a wave in ductus venosus waveform that is in 18%. In this study total 5 cases (35.7%) of perinatal mortality were seen.Conclusions: The knowledge of various doppler parameters may help to improve pregnancy outcome and identification of PIH at earliest gestation age as compared to other antepartum test modalities.


2020 ◽  
Vol 46 (9) ◽  
pp. 1766-1771
Author(s):  
Mehmet M. Işıkalan ◽  
Haççe Yeniçeri ◽  
Erzat Toprak ◽  
Filiz Y. Güleroğlu ◽  
Ali Acar

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