scholarly journals Uterine Artery Doppler Ultrasonography for First Trimester Prediction of Preeclampsia in Individuals at Risk from Low-Resource Settings

Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 428
Author(s):  
Mihaela Oancea ◽  
Mihaela Grigore ◽  
Razvan Ciortea ◽  
Doru Diculescu ◽  
Diana Bodean ◽  
...  
Keyword(s):  
At Risk ◽  
Pregnant Women ◽  
Uterine Artery ◽  
Doppler Ultrasonography ◽  
First Trimester ◽  
Prospective Longitudinal Study ◽  
Uterine Artery Doppler ◽  
Doppler Examination ◽  
Non Invasive ◽  
Prospective Longitudinal

Background and objectives: The objective of this study was to evaluate the potential of first trimester uterine artery Doppler ultrasonography for the early prediction of preeclampsia (PE), in at-risk pregnant women. Materials and Methods: This was a prospective longitudinal study, including 120 Caucasian pregnant women with risk factors for PE. The potential of pulsatility indexes (PI) and notch was assessed as a tool for preeclampsia screening. Results: Doppler examination of the uterine artery performed early at 11–14 WA allows the detection of pregnancies that will develop PE with a sensitivity of 61.5% and a specificity of 63.8% based on PI analysis. Predictive power increases slightly by adding bilateral notch (sensitivity = 65.4%; specificity = 66%). Conclusions: Uterine artery Doppler examination is an effective non-invasive screening test for the development of PE in pregnancies at risk, particularly appropriate in health systems with limited means of evaluating other biomarkers.

scholarly journals Maternal pregnancy associated plasma protein-A (PAPP-A) and uterine artery Doppler changes as predictors of pre-eclampsia: a prospective observational study from a teaching hospital in Mysore, Karnataka, India

2019 ◽  
Vol 8 (4) ◽  
pp. 1317
Author(s):  
Sharanya Satish ◽  
K. B. Suma ◽  
Madhu B. ◽  
Sujatha M. S.
Keyword(s):  
At Risk ◽  
Pregnant Women ◽  
Uterine Artery ◽  
Protein A ◽  
Resistance Index ◽  
Doppler Imaging ◽  
Hypertensive Disorder ◽  
Serum Samples ◽  
Uterine Artery Doppler ◽  
Low Serum

Background: Hypertensive disorder affects 10-12% of pregnancies. Identifying women, who are at risk is conducive to prompt gestational management. PAPP-A is a protein complex produced by the developing trophoblasts. Low levels of PAPP-A at 10–14 weeks is a marker of impaired placentation and a smaller placental mass. Doppler imaging permits non-invasive evaluation of the uteroplacental circulation and is invaluable in the management of high-risk pregnancies. The uterine artery Doppler screening identifies patients at risk for developing preeclampsia. To study the association of PAPP-A and the uterine artery Doppler changes as predictor of pre-eclampsia in pregnant women at 11-14 weeks of gestation.Methods: This was a prospective study of 150 pregnant women presenting at 11-14 weeks of gestation for a prenatal check-up. After considering the inclusion and exclusion criteria, serum samples for PAPP-A were assayed. Ultrasound Doppler was used to obtain uterine artery flow velocity waveforms and mean pulsatility index and resistance index of uterine arteries were calculated. Cases were followed up till term and observed for development of pre-eclampsia.Results: 48.6% had low serum PAPP-A levels, in which 77% developed PE. The Mean PI and RI is 2.34±1.16 and 0.58±0.1 respectively. 30% women with abnormal PI values and 24% of women with abnormal RI values developed PE.Conclusions: The combination of maternal history with low serum PAPP-A levels and abnormal uterine artery Doppler at 11-14 weeks can be used as predictor of pre-eclampsia.

Appearance of Abnormal Cardiothoracic Ratio of Fetuses with Hemoglobin Bart’s Disease: Life Table Analysis

2017 ◽  
Vol 38 (05) ◽  
pp. 544-548 ◽  
Author(s):  
Chanane Wanapirak ◽  
Supatra Sirichotiyakul ◽  
Suchaya Luewan ◽  
Kasemsri Srisupundit ◽  
Fuanglada Tongprasert ◽  
...  
Keyword(s):  
At Risk ◽  
Life Table ◽  
Peak Systolic Velocity ◽  
First Trimester ◽  
Life Table Analysis ◽  
Prospective Longitudinal Study ◽  
Cardiothoracic Ratio ◽  
Table Analysis ◽  
Prospective Longitudinal ◽  
Hb Bart's

Abstract Objective To determine the timeline of the first appearance of an increased CT ratio of fetuses with hemoglobin (Hb) Bart’s disease. Materials and Methods A prospective longitudinal study was conducted on pregnancies at risk for fetal Hb Bart’s disease. Sonographic markers including cardiothoracic (CT) ratio and middle cerebral artery peak systolic velocity (MCA-PSV) were serially assessed and recorded from the first trimester. The definite diagnosis of fetal Hb Bart’s disease based on DNA analysis (CVS), or fetal Hb typing (HPLC; cordocentesis) was performed at the first appearance of an increased CT ratio. Results Of 275 pregnancies at risk, 64 fetuses were finally proven to be affected and life table analysis was performed. Most affected fetuses showed an increased CT ratio in late first trimester and early second trimester, with median time of the first appearance at 13 weeks and all affected fetuses were detected at 23 weeks or less. The CT ratio yielded a sensitivity of 100 % at a gestational age of 23 weeks with a false-positive rate of 8 %. MCA-PSV appeared later than CT ratio. Only 9.4 % of affected cases developed abnormal MCA-PSV before an increased CT ratio. Conclusion The timeline of the first appearance of an increased CT ratio of fetuses with Hb Bart’s disease was established. This may help us identify Hb Bart’s disease among fetuses at risk in earlier gestation and proper schedules for serial ultrasound could be made more effectively.

scholarly journals Serum hypoxia-inducible factor-1α and uterine artery Doppler ultrasound during the first trimester for prediction of preeclampsia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wasinee Tianthong ◽  
Vorapong Phupong
Keyword(s):  
Pregnant Women ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Uterine Artery ◽  
Hypoxia Inducible Factor ◽  
First Trimester ◽  
Singleton Pregnancy ◽  
Uterine Artery Doppler ◽  
Hypoxia Inducible Factor 1Α ◽  
Sensitivity Specificity

AbstractThe objective of this study was to determine the predictive value of serum hypoxia-inducible factor-1α (HIF-1α) combined with uterine artery Doppler in singleton pregnancy during 11–13+6 weeks of gestation for preeclampsia. This prospective observational study was conducted in singleton pregnant women at 11–13+6 weeks of gestation who visited the King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University for antenatal care between February 2019 and May 2020. Serum HIF-1α levels and uterine artery Doppler ultrasound were performed. Pregnancy outcomes were recorded. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these tests at the optimal cut-off values were determined to predict preeclampsia. A total of 385 participants were analyzed. Of these, 31 cases had preeclampsia (8.1%), and 6 cases of them had early-onset preeclampsia (1.6%). Preeclamptic women had significantly higher serum HIF-1α levels than normal pregnant women (median 1315.2 pg/ml vs. 699.5 pg/ml, p < 0.001). There was no difference in the mean pulsatility (PI) of the uterine artery. Serum HIF-1α levels were higher than 1.45 multiple of median for the gestational age as a cut-off value for predicting preeclampsia; the sensitivity, specificity, PPV, and NPV were 66.7%, 71.5%, 17.2%, and 96.2%, respectively. When a combination of abnormal serum HIF-1α levels and abnormal uterine artery Doppler PI (above the 95th percentile) were used as a predictive value to predict preeclampsia, the sensitivity, specificity, PPV, and NPV were 74.2%, 67.2%, 16.6%, and 96.8%, respectively. This study showed that the serum HIF-1α levels with or without uterine artery Doppler at 11–13+6 weeks of gestation were effective in predicting preeclampsia.

scholarly journals First trimester maternal uterine artery Doppler examination in HIV-positive women

HIV Medicine ◽  
2011 ◽  
Vol 12 (10) ◽  
pp. 632-636 ◽  
Author(s):  
MD Savvidou ◽  
MI Samuel ◽  
R Akolekar ◽  
M Poulton ◽  
KH Nicolaides
Keyword(s):  
Uterine Artery ◽  
First Trimester ◽  
Hiv Positive ◽  
Uterine Artery Doppler ◽  
Doppler Examination ◽  
Hiv Positive Women

scholarly journals The Study of Predictive Value of Uterine Artery Doppler in Incidence of Preeclampsia and Intrauterine Growth Restrictions in Pregnant Women

2018 ◽  
Vol 7 (3) ◽  
pp. 354-359
Author(s):  
Sedigheh Borna ◽  
Shahla Nasrolahi ◽  
Shahedeh Khansari
Keyword(s):  
Pregnant Women ◽  
Predictive Value ◽  
Uterine Artery ◽  
Doppler Ultrasonography ◽  
Statistical Tests ◽  
Mean Difference ◽  
Statistical Population ◽  
Uterine Artery Doppler ◽  
Intrauterine Growth ◽  
The Mean

Objectives: Preeclampsia is considered as one of the most important causes of death among pregnant women all around the world. This study aimed to study the predictive value of uterine artery Doppler ultrasonography in the incidence of preeclampsia and the intrauterine growth restriction (IUGR) in pregnant women who attended Fatemieh hospital. Materials and Methods: This study was performed by the prospective cohort method and the statistical population included 108 pregnant women, in their 18-22 weeks of pregnancy, with a singleton pregnancy who referred to the prenatal Fatemieh Hospital of Hamadan during 2013-2016. The uterine artery Doppler ultrasonography was performed and the incidence of IUGR and the occurrence of preeclampsia in the followed pregnancy was evaluated in these patients. Data were analyzed by SPSS 16.0 using the chi-square and Mann-Whitney U statistical tests. Results: The mean difference of pulsatility index (PI) in patients with preeclampsia was statistically significant compared to healthy individuals (P=0.001). In addition, the mean difference of PI in individuals with infants suffering from IUGR was statistically significant compared with the infants not suffering from the IUGR (P=0.001). Further, the incidence of preeclampsia and IUGR in women with a bilateral notch in ultrasonography was significantly greater than those of the women with no report of a bilateral notch in ultrasonography (P=0.001). Conclusions: Therefore, Doppler ultrasonography of the uterine artery has a predictive value in preeclampsia among pregnant women.

COMPARATIVE ASSESSMENT OF MICROALBUMINURIAAND EARLY UTERINE ARTERY DOPPLER INDICES AS A PREDICTOR OF DEVELOPING PREECLAMPSIA.

2021 ◽  
pp. 21-24
Author(s):  
Monojit Chakrabarti ◽  
Chandreyee Dey ◽  
Sayani Mandal
Keyword(s):  
Uterine Artery ◽  
Late Pregnancy ◽  
Screening Tools ◽  
Chi Square ◽  
Prospective Longitudinal Study ◽  
Uterine Artery Doppler ◽  
Antenatal Period ◽  
Chi Square Test ◽  
Doppler Indices ◽  
Prospective Longitudinal

BACKGROUND : As we know hypertensive disorders in pregnancy is always a deadly threat to mothers and fetus. Mothers will be in large benet if we predict it earlier. Easy reproducible non cumbersome screening test are needed for it. METHODS: This is a Prospective longitudinal study. Patients were studied from rst trimester to late trimester in the department of g & o for 1 year who fullled the inclusion and exclusion criteria. They were observed through out the time period. All the data were studied by chi – square test . Ap value of <.05 was considered statistically signicant. RESULTS : Out of 150 antenatal mothers 12 developed pre-eclampsia (including 1 eclampsia) among which 8 had microalbuminuria during their antenatal period. 10 mothers had microalbuminuria but did not develop pre-eclampsia, 4 of them developed pre-eclampsia but they did not have microalbuminuria during antenatal period. 128 mothers did not have microalbuminuria and they did not develop pre-eclampsia When RI of >0.58 was used as cut off value at 18weeks of POG. In our study of 150 antenatal mothers 12 developed pre-eclampsia (including 1 eclampsia) among which 4 had RI of > 0.58 during their antenatal period. 6 of them had RI of >0.58 but did not develop pre-eclampsia, 8 of them developed pre-eclampsia but did not have increased RI value. 132 mothers did not have raised RI value and they did not develop pre-eclampsia. CONCLUSION Both the screening tools are easy to done. Microalbuminuria and early uterine artery doppler indices can be used as predictor of detecting preeclampsia. Mothers with no microalbuminuria and uterine artery RI value of < 0.58 would have less chance of developing pre eclampsia in late pregnancy.

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