P8 Mid-trimester uterine artery Doppler screening in prediction of preeclampsia in high risk women

Pongrojpaw, Densak; Somprasit, Charintip; Chanthasenanont, Athita; Nanthakomon, Tongta

doi:10.1016/s2210-7789(10)60174-2

Cited by 11 publications

(17 citation statements)

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“…Several investigators have suggested that diastolic notch in the uterine artery as a single parameter is better than the individual Doppler indices 15,17,18 , while others are more in favour of using the PI 12,19 .Given the technological improvements in the Doppler hardware and software 20 , ultimately the ability to measure accurately the increased impedance to uterine artery flow in both high risk and low risk pregnancies becomes crucial to predict the risk for subsequent development of pre-eclampsia and fetal growth restriction. The findings from this research show that women with normal impedance to flow in the uterine arteries constitute a group that have a low risk (negative predictive value for pre-eclampsia is 99% and for SGA < 5th percentile is 93%) of developing obstetric complications related to Uteroplacental insufficiency, as observed by others 14,21 .…”

Section: Discussionsupporting

confidence: 65%

“…Over the past two decades, several investigators have explored the validity of Uterine artery Doppler flow velocity waveforms as predictors of pre-eclampsia, fetal growth restriction, and adverse perinatal outcomes notches, increased pulsality indices 2,7,8. Yet, there has been no consensus on several aspects of Doppler ultrasonography in terms of the best time for assessment, the optimal outcome parameters, cut-off thresholds to obtain maximum predictive powers, and relationship of prediction to prevalence of the adverse events 13,14 . The findings of the present study done several years ago in south India seem still valid in terms of the timing, parameters and optimal screening efficacies (Table 1 and 2).…”

Section: Discussionmentioning

confidence: 99%

“…The negative predictive values being high, Doppler can reduce the anxiety and burden on high risk women, as women with normal Doppler are unlikely to develop preeclampsia, and severe FGR 14 . In the light of the findings from various research studies, not all consistent, there has been much debate on whether Doppler ultrasonography should be routinely used in obstetrical practice [23][24][25][26] .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Predicting Pre-Eclampsia & Fetal Growth Restriction through Second Trimester Uterine Artery Doppler Sonography: An Indian experience

Padmalatha¹

2013

IOSR-JDMS

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Predicting Pre-Eclampsia & Fetal Growth Restriction through Second Trimester Uterine Artery Doppler Sonography: An Indian experience

Padmalatha¹

2013

IOSR-JDMS

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“…We demonstrated abnormal PI in uterine arteries in 62.7 % of fetuses from pregnancy induced hypertension, 30 % of fetuses with FGR, and 4.5 % of fetuses with antepartal hemorrhage (Table 12), which was in concordance with previous studies [4,5] . According to a study by Pongrojpaw et al, in high-risk women, mid-trimester uterine artery Doppler waveform analysis cannot be used as a screening method in women at higher risk for the development of severe adverse outcome, such as pre-eclampsia and small for gestational age babies [25] . However, women with normal uterine artery Doppler results are unlikely to develop pre-eclampsia, FGR, and therefore do not necessarily need repeated Doppler ultrasound follow-up [25] .…”

Section: Umbilical Arteries (Uas)mentioning

confidence: 99%

“…According to a study by Pongrojpaw et al, in high-risk women, mid-trimester uterine artery Doppler waveform analysis cannot be used as a screening method in women at higher risk for the development of severe adverse outcome, such as pre-eclampsia and small for gestational age babies [25] . However, women with normal uterine artery Doppler results are unlikely to develop pre-eclampsia, FGR, and therefore do not necessarily need repeated Doppler ultrasound follow-up [25] .…”

Section: Umbilical Arteries (Uas)mentioning

confidence: 99%

Comparison between antenatal neurodevelopmental test and fetal Doppler in the assessment of fetal well being

Kurjak

Talić

Honemeyer

et al. 2012

Journal of Perinatal Medicine

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Aims: The primary aim of this study was to compare circulatory changes in the fetal brain under certain pathological conditions with alterations in fetal behavior. Patients and methods: A prospective longitudinal cohort study on fetal behavior of fetuses from singleton pregnancies between the 28 th and 38 th gestational week in the period from March 2009 to October 2011 was undertaken. There were 596 fetuses in the high-risk group and 273 fetuses in the low-risk group. Elevated umbilical artery Doppler pulsatility index and reduced middle cerebral artery pulsatility index obtained in the absence of fetal movements were considered abnormal. The Kurjak Antenatal Neurodevelopmental Test (KANET) was used to assess fetal behavior. Results: Statistically signifi cant differences in the distribution of normal, abnormal, and borderline KANET scores between low-risk and high-risk groups were found. Furthermore, 596 fetuses from the high-risk group were subdivided into subgroups according to the risk factor. The largest proportion of abnormal KANET scores (23.9 % ) was in the subgroup of fetuses whose mothers had an offspring diagnosed with cerebral palsy (23.9 % ), followed by the proportion of borderline KANET scores in the subgroup of fetuses from febrile mothers (12.7 % ). Fetal behavior was signifi cantly different between the normal group and the following subgroups of fetuses: fetal growth restriction (FGR), gestational diabetes mellitus, threatened preterm birth, antepartal hemorrhage, maternal fever, sibling with cerebral palsy, and polyhydramnios. Conclusions: A new clinical application of the KANET test in early identifi cation of fetuses at risk for adverse neurological outcome was demonstrated.

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Human Placenta Blood Flow During Early Gestation With Pseudocontinuous Arterial Spin Labeling MRI

Liu

Shao

Danyalov

et al. 2019

Magnetic Resonance Imaging

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Background Noninvasive measurement of placental blood flow is the major technical challenge for predicting ischemic placenta (IPD). Pseudocontinuous arterial spin labeling (pCASL) MRI was recently shown to be promising, but the potential value in predicting the subsequence development of IPD is not known. Purpose To derive global and regional placental blood flow parameters from longitudinal measurements of pCASL MRI and to assess the associations between perfusion‐related parameters and IPD. Study Type Prospective. Population Eighty‐four women completed two pCASL MRI scans (first; 14–18 weeks and second; 19–24 weeks) from prospectively recruited 118 subjects. A total of 69 subjects were included for the analysis, of which 15 subjects developed IPD. Field Strength/Sequence 3T/T2‐weighted half‐Fourier single‐shot turbo spin‐echo (HASTE) and pCASL. Assessment Four perfusion‐related parameters in the placenta were derived: placenta volume, placental blood flow (PBF), high PBF (hPBF), and relative hPBF. The longitudinal changes of the parameters and their association with IPD were tested after being normalizing to the 16th and 20th weeks of gestation. Statistical Tests Comparisons between two gestational ages within subjects were performed using the paired Wilcoxon tests, and comparisons between normal and IPD groups were performed using the unpaired Wilcoxon tests. Results The difference between the first and second MRI scans was statistically significant for volume (156.6 cm3 vs. 269.7 cm3, P < 0.001) and PBF (104.9 ml/100g/min vs. 111.3 ml/100g/min, P = 0.02) for normal subjects, indicating an increase in pregnancy with advancing gestation. Of the parameters tested, the difference between the normal and IPD subjects was most pronounced in hPBF (278.1 ml/100g/min vs. 180.7 ml/100g/min, P < 0.001) and relative hPBF (259.1% vs. 183.2%, P < 0.001) at 16 weeks. Data Conclusion The high perfusion‐related image parameters for IPD were significantly decreased from normal pregnancy at 14–18 weeks of gestation. Level of Evidence 2 Technical Efficacy Stage 1 J. Magn. Reson. Imaging 2020;51:1247–1257.

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P8 Mid-trimester uterine artery Doppler screening in prediction of preeclampsia in high risk women

Cited by 11 publications

References 0 publications

Predicting Pre-Eclampsia & Fetal Growth Restriction through Second Trimester Uterine Artery Doppler Sonography: An Indian experience

Predicting Pre-Eclampsia & Fetal Growth Restriction through Second Trimester Uterine Artery Doppler Sonography: An Indian experience

Comparison between antenatal neurodevelopmental test and fetal Doppler in the assessment of fetal well being

Human Placenta Blood Flow During Early Gestation With Pseudocontinuous Arterial Spin Labeling MRI

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