Document Detail


Longitudinal trends in feto-placental biochemical markers, uterine artery Doppler flow velocities and maternal blood pressure during the first-trimester of pregnancy.
MedLine Citation:
PMID:  21520474     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To assess trends in biochemical markers, uterine artery Doppler flow velocities and maternal blood pressure (BP) changes over time and study their relationships in uncomplicated first-trimester pregnancies. METHODS: This study comprised 108 women with singleton pregnancies. In each woman 4 venous blood samples were collected serially every two weeks starting from 6-7 until 12-13 weeks' gestation. At the same visit BP was measured and ultrasound examination was performed to measure the crown-rump length (CRL) and Doppler flow velocity waveform patterns of both uterine arteries (Ut-A). Serum concentrations of PAPP-A, fβ-hCG, ADAM12, PP13 and PlGF were measured in thawed specimens using a (automated) time resolved fluorescence assay (autoDELFIA and DELFIA Xpress; PerkinElmer, Turku, Finland). Summary curves were created to describe normal ranges and trends with time. A linear mixed model was used with the log-transformed marker values as dependent variable. This allowed for flexible modelling of patterns over time. RESULTS: 68 pregnancies had an uneventful outcome, with the birth of an appropriate-for-dates infant. In these pregnancies serum PAPP-A, ADAM12, PP13 and PlGF increased with gestational age. The Ut-A Doppler Pulsatility Index (PI) decreased and the mean arterial BP remained constant. There were no significant correlations between maternal age, birthweight percentile, gender and blood pressure and any of the biochemical markers. The serum markers were highly correlated except for fβ-hCG. A negative correlation was found between the biomarkers and the Ut-A Doppler PI, especially from 10 weeks onwards. Serum concentrations of ADAM12 and PP13 were reduced in a small-for-gestational age subgroup born at term (n= 6, P = 0.031, and P = 0,054 (NS), respectively), whereas the Ut-A Doppler PI was significantly increased (P = 0.02). Biomarker concentrations in 12 women delivering a large-for-gestational age infant did not differ from controls. CONCLUSION: There is a relation between biochemical markers of early placentation and downstream resistance to flow in the uterine arteries in low risk uncomplicated pregnancies, indicating differences in placentation. In a small series of SGA infants born at term we could demonstrate differences as compared to the normal pregnancies, with potential value for screening. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
E J Wortelboer; M P H Koster; S Kuc; M J C Eijkemans; C M Bilardo; P C J I Schielen; G H A Visser
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-26
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands. E.Wortelboer@umcutrecht.nl.
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