Pathological placentation and prediction of preeclampsia and intrauterine growth restriction in the first trimester

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.

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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

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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

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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.

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