First Trimester Prediction of Adverse Pregnancy Outcomes—Identifying Pregnancies at Risk from as Early as 11–13 Weeks

Bouariu, Alexandra; Panaitescu, Anca Maria; Nicolaides, Kypros H.

doi:10.3390/medicina58030332

Cited by 10 publications

(6 citation statements)

References 27 publications

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“…Notably, ultrasound markers indicative of PASD and serum diagnostic markers, such as human chorionic gonadotropin, can manifest during the first trimester, enabling assessment and prediction of PASD severity in the first and second trimesters [ 12–14 ]. Early intervention can enhance pregnancy outcomes [ 13 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Termination of a second-trimester pregnancy with placenta accreta spectrum disorder

Li,

Zhang,

et al. 2023

Libyan Journal of Medicine

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Background: The termination of pregnancy in patients with placenta accreta spectrum disorder (PASD) during the second trimester remains uncertain. In addition, interventional radiology techniques, such as arterial embolization and balloon placement, are potential options. We evaluated the outcomes of pregnancy termination in patients with PASD during the second trimester and the effectiveness of preoperative interventional radiology techniques. Methods: This retrospective study analyzed 48 PASD patients who underwent pregnancy termination during the second trimester between January 2016 and May 2021. Results: Of the 48 patients, 20 (41.67%) underwent transvaginal termination, whereas 28 (58.33%) underwent cesarean section. Notably, no significant differences were observed in success rates between the transvaginal termination and cesarean section groups (80.00% vs. 92.86%, P = 0.38). Furthermore, no statistically significant differences were observed in the success rates (94.12% vs 90.32%, P = 1.00) and blood loss (512.35 ± 727.00 ml vs 804.00 ± 838.98 ml, P = 0.23) between the artery embolization and non-embolization groups. In the vaginal termination group, statistically significant differences were observed in gestational weeks (16.70 ± 3.12 vs 22.67 ± 3.63, P < 0.01) and blood loss (165.00 ± 274.43 ml vs 483.64 ± 333.53 ml, P = 0.04) between the (artery embolization and non-embolization) subgroups. Conversely, in the cesarean section group, no significant differences were observed in gestational weeks (23.59 ± 3.14 vs 23.20 ± 4.37, P = 0.79) and blood loss (811.11 ± 879.55 ml vs 989.47 ± 986.52 ml, P = 0.76) between the subgroups. Conclusions: Further studies are needed to evaluate the efficacy of vaginal termination in PASD patients during the second trimester. Regarding cesarean termination, arterial embolization did not demonstrate increased effectiveness.

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Section: Discussionmentioning

confidence: 99%

Termination of a second-trimester pregnancy with placenta accreta spectrum disorder

Li,

Zhang,

et al. 2023

Libyan Journal of Medicine

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“…First-trimester screening for chromosomal anomalies is a milestone in pregnancy monitoring. The fact that screening with a combination of fetal ultrasound, maternal serum free-beta-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) can identify 90% of fetuses with trisomy 21 and other major chromosomal abnormalities with a false-positive rate of 5% [1] has drawn doctors' and researchers' attention to the possibility of screening for other pregnancy-related conditions. Scientists worldwide have concentrated on finding the first-trimester serum markers that predict other pregnancy complications.…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies have shown that certain maternal conditions may be predicted in the first trimester. Screening a combination of maternal factors and measuring mean arterial pressure, uterine pulsatility index, and serum placental growth factor may predict 90% of early preeclampsia cases, before 32 weeks, and 75% of preterm preeclampsia cases, before 37 weeks, with a 10% false-positive rate [1].…”

Section: Introductionmentioning

confidence: 99%

“…This study aimed to examine the association of subclinical hypothyroidism and the presence of thyroid autoantibodies in the first-trimester pregnancy with impaired glucose metabolism and to determine the potential predictive value of the elevated thyroidstimulating hormone and the presence of antithyroid antibodies in gestational diabetes mellitus screening. Existing screening tests for gestational diabetes mellitus use maternal characteristics, family, and personal history to assess the risk of one specific condition [1]. The possibility of using screening markers of thyroid function in the early first trimester of pregnancy to assess the risk of gestational diabetes mellitus might allow one test to identify the risk for two clinically important conditions, enabling appropriate and specific treatment for pregnant women at risk.…”

Section: Introductionmentioning

confidence: 99%

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Can Thyroid Screening in the First Trimester Improve the Prediction of Gestational Diabetes Mellitus?

Milovanović

Filimonović

Soldatović

et al. 2022

JCM

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This study aimed to evaluate the clinical utility of the subclinical hypothyroidism (SCH) marker, elevated thyroid-stimulating hormone (TSH) and thyroid antibodies in their ability to predict subsequent gestational diabetes mellitus (GDM). In a prospective clinical trial, 230 pregnant women were screened for thyroid function during the first trimester of pregnancy. Increased TSH levels with normal free thyroxine (fT4) were considered SCH. The titers of thyroid peroxidase antibody (anti TPO Ab) at >35 IU/mL and thyroglobulin antibody (anti Tg Ab) at >115 IU/mL were considered as antibodies present. According to the OGTT results, the number of pregnant women with GDM showed the expected growth trend, which was 19%. Two groups of pregnant women were compared, one with GDM and the other without. Increased TSH levels and the presence of thyroid antibodies showed a positive correlation with the risk of GDM. TSH levels were significantly higher in pregnant women with GDM, p = 0.027. In this study, 25.6% of pregnant women met the diagnostic criteria for autoimmune thyroiditis. Hashimoto’s thyroiditis was significantly more common in GDM patients, p < 0.001. Through multivariate logistic regression, it was demonstrated that patient age, TSH 4 IU/mL, and anti TPO Ab > 35 IU/mL are significant predictors of gestational diabetes mellitus that may improve first-trimester pregnancy screening performance, AUC: 0.711; 95% CI: 0.629–0.793.

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“…Варто зазначити, що саме плацентарне ложе є джерелом великої кількості біологічно актив-них речовин, які визначають перебіг гестації [10]. Тому на сьогодні до прогностичних моделей, які дають змогу встановити ризик ускладнень і визначити доцільність проведення профілактичних заходів, окрім різноманітних анамнестичних факторів, належать і лабораторні та інструментальні індикатори функції плаценти [4,14].…”

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The features of the functioning of the fetoplacental complex in pregnant women with an allogeneic fetus

Romanenko,

Yesyp

2024

UJPP

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Aim - to determine the features of the functional state of the fetoplacental complex (FPC) in pregnant women with an allogeneic fetus and pregnant women who were involved in assisted reproductive technology (ART) programs using their own oocytes. Materials and methods. 77 pregnant women were examined. They were divided into two groups: Group I (main) - 39 women who became pregnant as a result of ART using donor oocytes with the formation of an allogeneic fetus; Group II (comparison) - 38 patients who became pregnant as a result of ART using their own oocytes. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs. Results. Pregnant women with an allogeneic fetus are characterized by significantly lower levels of pregnancy-associated plasma protein-A (PAPP-A) and placental growth factor (PlGF), determined at 11-13+6 weeks of pregnancy, and human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP) levels, measured at 16-18+6, compared with a group of women whose own oocytes were used as part of ART programs. In the women of Group I, significantly higher levels of systolic-to-diastolic ratio (SDR) and pulsatility index (PI) of both uterine arteries, resistance index (IR) of the left uterine artery at 20-24 weeks of pregnancy, as well as levels of PI and SDR of the umbilical artery, IR and PI of both uterine arteries and SDR determined for the left uterine artery at 28-31+6 weeks of pregnancy. In Group I, a significantly lower fetal abdominal circumference was found in comparison to Group II at 28-31+6 weeks of pregnancy. Conclusions. The presence of deviations in the indicators of FPC functioning among women of Group I indicates the need for further research of this problem and development of an improved surveillance program for pregnant women with an allogeneic fetus. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution indicated in the work. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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First Trimester Prediction of Adverse Pregnancy Outcomes—Identifying Pregnancies at Risk from as Early as 11–13 Weeks

Cited by 10 publications

References 27 publications

Termination of a second-trimester pregnancy with placenta accreta spectrum disorder

Termination of a second-trimester pregnancy with placenta accreta spectrum disorder

Can Thyroid Screening in the First Trimester Improve the Prediction of Gestational Diabetes Mellitus?

The features of the functioning of the fetoplacental complex in pregnant women with an allogeneic fetus

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