Placental and fetal hemodynamics in prolonged pregnancies

Kauppinen, Tuomas; Kantomaa, Tiina; Tekay, Aydin; Mäkikallio, Kaarin

doi:10.1002/pd.4828

Cited by 11 publications

(4 citation statements)

References 38 publications

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“…In contrast, recent studies indicate that the Doppler indices UA, UtA, MCA, and DV are not useful in the follow-up of post-term pregnancies or in predicting and preventing adverse fetal and perinatal outcomes. 5,11 Consistent with these studies, we found that Doppler indices were not predictors of adverse outcomes in women at ≥40 weeks of pregnancy.…”

Section: Discussionsupporting

confidence: 81%

“…4 Although it is known that the continuation of pregnancy after the expected delivery time increases perinatal mortality, the time to start fetal monitoring and the gestational week to intervene remain controversial is-sues. 5 Doppler velocimetry is a non-invasive method for evaluating uteroplacental circulation. Many uterine artery Doppler studies have shown a relationship between increased wave resistance in uterine artery flow and preeclampsia and/or fetal growth retardation in the second trimester of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of adverse perinatal outcomes in women at 40 weeks or more of pregnancy

Sert,

Dilmaç,

Alkan

et al. 2023

Eur J Clin Exp Med

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Introduction and aim. To evaluate the clinical features of women at ≥40 weeks of pregnancy and the utility of obstetric Doppler indices in predicting adverse perinatal outcomes in these pregnancies. Material and methods. This prospective study was conducted at a single academic medical center between 2020 and 2022. Women aged 18 years and older with no risk factors who were at ≥40 weeks of pregnancy and delivered their babies in our hospital were included in the study. The fetal biometry, placental maturity grading, and doppler velocytometry indices of the pregnant women were evaluated. The cases were divided into two groups according to the development of adverse perinatal outcomes. The relationship between clinical features and adverse perinatal outcomes was evaluated. Results. Adverse perinatal outcomes developed in 19.6% (42) of the 214 cases. The multiple logistic regression analysis was performed to identify factors affecting perinatal outcomes. Accordingly, a maternal age of ≥35 years (odds ratio [OR]: 1.74, 95% confidence interval [CI]: 1.29–3.96, p=0.038), nulliparity (OR: 1.42, 95% CI: 1.13–4.63, p=0.040), and grade 3 placental calcification (OR: 1.98, 95% CI: 1.11–4.53, p=0.029) were independent predictors of adverse perinatal outcomes. Conclusion. Care should be taken in terms of adverse perinatal outcomes in the presence of nulliparity, a maternal age of ≥35 years, and grade 3 placental calcification in ≥40 week pregnancies.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Predictors of adverse perinatal outcomes in women at 40 weeks or more of pregnancy

Sert,

Dilmaç,

Alkan

et al. 2023

Eur J Clin Exp Med

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“…Post-term olgular (15). Son olarak Kauppinen ve arkadaşları, 41 hafta üzerindeki hastalarda olumsuz perinatal sonuçları olan ve olmayan iki grupta uterin, umbilikal, orta serebral arter ve CPR oranlarını karşılaştırmıştır (16). Her iki grupta Doppler verileri açısından fark gösterilememiştir.…”

Section: Geç-term Olgular (N=67)unclassified

Comparison of fetal Doppler blood flow characteristics of late-term and post-term pregnancies

Güneş¹,

Oğlak

2020

Ege Tıp Dergisi

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ÖzAmaç: Çalışmanın amacı, 41 hafta ve üzeri komplike olmayan geç-term ve post-term gebeliklerde fetal Doppler akım özelliklerini karşılaştırmak ve bunların doğum sonrası sonuçlara etkisini değerlendirmektir. Gereç ve Yöntem: Ümraniye Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Polikliniği'ne başvuran düşük risk grubundaki toplam 98 geç-term ve post-term tekiz gebe çalışma grubuna alındı. Tüm gebelerin gebelik haftası, son adet tarihi ve erken dönem ultrasonografi verileri ile teyit edilerek hesaplandı. Hastalara sonografik değerlendirme ile tahmini fetal kilo, amniyotik sıvı hacmi, biyofizik profil ve Doppler (fetal umbilikal arter, orta serebral arter ve maternal uterin arter) incelemeleri yapıldı. Orta serebral ve umbilikal arterlerde pulsatilite ve rezistans indeksleri ile serebroplasental oran Doppler ultrasonografi ile günlük olarak değerlendirildi. Bu gebelerin doğum şekli, yenidoğan doğum kilosu, doğumda mekonyumlu amniotik sıvı varlığı, NST'de fetal distres bulgusu varlığı, yenidoğan 5. dakika Apgar skoru, fetal distres varlığında kordon kan gazı pH değeri ve yenidoğan yoğun bakım ünitesi ihtiyacı olup olmadığı kayıt altına alındı. Bulgular: Her iki grubun ortalama uterin arter ve ortalama umbilikal arter pulsatilite indeksleri ile orta serebral arter rezistans indeksi değerleri arasında fark gösterilememiştir. Post-term grupta ortalama umbilikal arter rezistans indeksi ve orta serebral arter pulsatilite indeksi değerleri anlamlı olarak daha düşük bulunmuştur. Geç-term grupta serebroplasental oran daha düşük olsa da bu farklılık istatistiksel olarak anlamlı değildir. Her iki grupta, bebeklerin yeni doğan yoğun bakım ünitesine yatma oranları arasında anlamlı bir fark saptanmadı. Sonuç: Anormal ve normal serebroplasental oran sonucuna göre yenidoğanın iyilik hali ve yoğun bakım ünitesinde yatma ihtiyacı açısından anlamlı ilişki saptanmamasına rağmen daha geniş serili çalışma gruplarına ihtiyaç olduğu düşünülmektedir. Anahtar Sözcükler: Serebroplasental oran, orta serebral arter, umbilikal arter.

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“…Numerous methods, such as fetal Doppler parameters and computerized cardiotocography, are used to monitor placental function and fetal wellbeing. Nevertheless, these methods have not been demonstrated to be efficacious in predicting the outcomes of prolonged pregnancies [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Amniotic fluid and umbilical cord serum erythropoietin in term and prolonged pregnancies

Seikku

Stefanović

Rahkonen

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective. Erythropoietin-a hormone regulating erythropoiesis-is a biomarker of chronic fetal hypoxia. High erythropoietin levels in fetal plasma and amniotic fluid are associated with increased risk of adverse neonatal outcome. Since the risk of perinatal morbidity and mortality is increased in pregnancies beyond 41 gestational weeks, we evaluated erythropoietin levels in amniotic fluid and umbilical cord serum in apparently low-risk term (≥37 gestational weeks) and prolonged pregnancies (≥41 gestational weeks) with labor induction. Study Design. This prospective cohort study comprised 93 singleton pregnancies at 37 +0-42 +1 gestational weeks, of which prolonged pregnancies numbered 63 (67.7%). Amniotic fluid samples were collected at time of labor induction by amniotomy. Umbilical cord blood samples for evaluation of pH, base excess, and umbilical cord serum erythropoietin were collected at birth. Erythropoietin levels were measured by immunochemiluminometric assay. Normal value of amniotic fluid erythropoietin level was defined as ≤3 IU/L, and abnormal value as ≥27 IU/L. Normal umbilical cord serum erythropoietin was defined as <40 IU/L. Data on maternal pregnancy and delivery characteristics and short-term neonatal outcomes such as Apgar score were obtained from the hospital charts. Associations were calculated using Spearman's rank correlation coefficient. The Chi-square test, Fisher's exact test and the Mann-Whitney U test were utilized to determine differences in the study groups. Results. Amniotic fluid erythropoietin levels correlated with gestational age (r=0.261, p=0.012) and were higher among prolonged pregnancies as compared to term pregnancies (p=0.005). There were 78 (83.9%) vaginal deliveries, and among these erythropoietin levels in amniotic fluid correlated with the levels in umbilical cord serum (r=0.513, p<0.000). Umbilical cord serum erythropoietin levels correlated with gestational age among vaginal deliveries (r=0.250, p=0.027). Erythropoietin levels in amniotic fluid and umbilical cord serum did not correlate with umbilical artery pH or base excess, or other adverse pregnancy outcome. Conclusions. In vaginal deliveries erythropoietin levels in amniotic fluid correlated with the levels in umbilical cord serum. Erythropoietin levels correlated with gestational age, probably due to weakening placental function and relative hypoxemia occurring in advanced gestation. However, in this relatively low-risk study population erythropoietin was not related to adverse delivery outcome.

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Placental and fetal hemodynamics in prolonged pregnancies

Cited by 11 publications

References 38 publications

Predictors of adverse perinatal outcomes in women at 40 weeks or more of pregnancy

Predictors of adverse perinatal outcomes in women at 40 weeks or more of pregnancy

Comparison of fetal Doppler blood flow characteristics of late-term and post-term pregnancies

Amniotic fluid and umbilical cord serum erythropoietin in term and prolonged pregnancies

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