Document Detail


Mid-trimester placentation assessment in high-risk pregnancies using maternal serum screening and uterine artery Doppler.
MedLine Citation:
PMID:  16263599     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the value of uterine artery velocimetry and mid-trimester maternal serum AFP/hCG measurements in predicting pregnancy complications in a high-risk group of pregnant patients. METHODS: Eighty-eight patients with chronic hypertension, previous preeclampsia, and thrombophilia were included. Maternal serum AFP/hCG was examined between 15-16 weeks gestation. Levels > 3 multiple of median (MoM) for hCG and > 2 MoM for AFP were considered abnormal. Color Doppler ultrasound was performed at 23-24 weeks gestation. Diastolic notching and pulsatility index (PI) above the 95th percentile were considered abnormal. RESULTS: Thirty-three patients had abnormal uterine artery waveform: 8 patients had abnormal maternal serum hCG and 5 had abnormal maternal serum AFP. Bilateral abnormal uterine artery waveform was associated with pregnancies complicated by lower gestational age at delivery (p=0.05) and birth weight (p<0.01), higher rates of preeclampsia (p=0.006), SGA (p=0.0001), preterm delivery (p=0.0001), and cesarean section rate (p<0.0001) in comparison to patients with normal uterine artery Doppler. Pregnant women with elevated hCG had higher rates of preeclampsia (p=0.006); preterm delivery (p=0.005) and SGA (P=0.03) and, lower birth weight (p=0.001). No significant differences were noted for clinical outcomes according to AFP data. Conclusions. Abnormal uterine artery waveform is superior to maternal serum hCG for identification of placental pathology leading to preterm delivery, low birth weight, and preeclampsia in high-risk pregnant patients.
Authors:
Reli Hershkovitz; Michael de Swiet; John Kingdom
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hypertension in pregnancy : official journal of the International Society for the Study of Hypertension in Pregnancy     Volume:  24     ISSN:  1064-1955     ISO Abbreviation:  Hypertens Pregnancy     Publication Date:  2005  
Date Detail:
Created Date:  2005-11-02     Completed Date:  2006-05-04     Revised Date:  2009-05-12    
Medline Journal Info:
Nlm Unique ID:  9421297     Medline TA:  Hypertens Pregnancy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  273-80     Citation Subset:  IM    
Affiliation:
Maternal Medicine Clinic, The Obstetric Hospital, University College London Hospitals NHS Trust, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arteries / ultrasonography
Chorionic Gonadotropin / blood
Female
Humans
Hypertension / physiopathology
Placentation / physiology*
Pre-Eclampsia / physiopathology
Predictive Value of Tests
Pregnancy
Pregnancy Complications / ultrasonography
Pregnancy Outcome
Pregnancy Trimester, Second
Pregnancy, High-Risk*
Thrombophilia / physiopathology
Ultrasonography, Doppler
Ultrasonography, Prenatal
Uterus / blood supply*
alpha-Fetoproteins / metabolism
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/alpha-Fetoproteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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