Physiopathology

Tonni, Gabriele; Júnior, Edward Araujo; Bonasoni, Maria Paola

doi:10.1007/978-3-030-00051-6_4

Cited by 3 publications

(3 citation statements)

References 143 publications

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“… 25 The onset of ASA at the 1 st trimester of pregnancy has shown to have an effect on the reduction of the incidence of preterm PE in high-risk patients 19 and of the incidence for small for gestational age (SGA) and fetal growth restriction (FGR). 20 However, there are very few studies that evaluate the performance of the mean UtA-PI in patients taking ASA.…”

Section: Discussionmentioning

confidence: 99%

“… 17 18 Recently, The Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Pre-eclampsia Prevention (ASPRE) trial reported that ASA at a dose of 150 mg per day, started between 11 and 14 weeks, reduces the incidence of preterm PE by 62% in patients with a high risk of developing PE, 19 but a meta-analysis aimed at assessing the impact of the start of ASA intake at the 2 nd trimester in women with abnormal UtA-PI showed no benefit regarding the reduction of PE, suggesting that its action is lost after week 16. 20 Currently, there are not enough data to explain how the mean UtA-PI behaves as the gestation progresses when women take ASA before 14 weeks and it has not been explored whether ASA could modify the 95 th percentile of mean UtA-PI when patients with high risk of PE at the 2 nd and 3 rd trimesters are followed-up. The present study aimed to analyze whether ASA intake could modify the mean UtA-PI at the 2 nd or 3 rd trimesters in a cohort of pregnant women with abnormal mean UtA-PI (PI > 95 th percentile) at the 1 st trimester.…”

Section: Introductionmentioning

confidence: 99%

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Could Aspirin Treatment Modify the Assessment of the Uterine Arteries?

Vallejo

Uriel

Porras-Ramírez

et al. 2022

Rev Bras Ginecol Obstet

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Objective To analyze whether acetylsalicylic (ASA) intake modifies the mean uterine arteries pulsatility index (UtA-PI) at the 2nd or 3rd trimester in a cohort of pregnant women with abnormal mean UtA-PI at between 11 and 14 weeks of gestation. Methods This is a retrospective cohort study. Singleton pregnancies with abnormal mean UtA-PI at between 11 and 14 weeks of gestation were studied. The participants were divided into 3 groups: 1) If the participant did not take ASA during pregnancy; 2) If the participant took ASA before 14 weeks of gestation; and 3) If the participant took ASA after 14 weeks of gestation. The mean UtA-PI was evaluated at the 2nd and 3rd trimesters, and it was considered to improve when it decreased below the 95th percentile. The prevalence ratio (PR) and the number needed to treat (NNT) were calculated. Results A total of 72 participants with a mean UtA-PI > 95th percentile at the 1st trimester of gestation were evaluated. Out of the 18 participants who took ASA, 8 participants started it before 14 weeks of gestation and 10 after. A total of 33.3% of these participants had improved the mean UtA-PI at the 2nd and 3rd trimesters of gestation, although it was not statistically significant (p = 0.154). The prevalence ratio was 0.95 (95% confidence interval [CI]: 0.31–1.89), but between the 1st and 2nd trimesters of gestation, the PR was 0.92 (95%CI: 0.21–0.99) and it was statistically significant. Conclusion The present work demonstrates a modification of the mean UtA-PI in participants who took ASA compared with those who did not. It is important to check if ASA can modify the normal limits of uterine arteries because this could have an impact on surveillance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Could Aspirin Treatment Modify the Assessment of the Uterine Arteries?

Vallejo

Uriel

Porras-Ramírez

et al. 2022

Rev Bras Ginecol Obstet

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“…Increased vascular resistance of the uterine artery indicates failed remodeling of the vessels of the intervillous space. 3,5,6 A systematic reviews showed that an increase of uterine artery pulsatility index (PI) alone and/or combined with the presence of a uterine artery notching are better predictors of preeclampsia in the second trimester than in the first trimester. 7 Angiogenic imbalance is another hypothesis.…”

Section: Introductionmentioning

confidence: 99%

Prediction of preeclampsia using a combination of serum micro RNA-210 and uterine artery Doppler ultrasound

Trongpisutsak

Phupong

2021

Science Progress

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The objective was to determine whether a combination of serum micro RNA-210 level and uterine artery Doppler can predict preeclampsia in pregnant women at 16–24 weeks gestation. A prospective observational study conducted in singleton pregnant women at 16–24 weeks of gestation who had prenatal care at the King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand between 2017 and 2018. Uterine artery Doppler ultrasound and blood testing for serum micro RNA-210 were performed. Pregnancy outcomes were recorded. Optimal cut-off for uterine artery pulsatility index (PI) and serum micro RNA-210 were obtained to calculate the predictive values for preeclampsia. Data from 443 participants were analyzed. Twenty-two cases developed preeclampsia (5.0%) and seven of these preeclamptic cases had early-onset preeclampsia (1.6%). Pregnant women with preeclampsia had higher mean PI of the uterine artery (1.34 ± 0.52 vs 0.98 ± 0.28, p = 0.004), higher detection rates of diastolic notching (45.5% vs 11.2%, p < 0.001), and lower median serum micro RNA-210 level (22.86 vs 795.78, p < 0.001) than pregnant women without preeclampsia. Using abnormal serum micro RNA-210 level, abnormal mean PI or uterine artery diastolic notches to predict for preeclampsia, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 95.5%, 54.9%, 10.0%, and 99.6%, respectively. For early-onset preeclampsia prediction, the sensitivity, specificity, PPV, and NPV were 100.0%, 53.2%, 3.3%, and 100.0%, respectively. This study demonstrated that a combination of serum micro RNA-210 and uterine artery Doppler is effective in predicting preeclampsia in the second trimester.

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