Reference range of uterine artery Doppler parameters between the 11th and 14th pregnancy weeks in a population sample from Northeast Brazil

Alves, Júlio Augusto Gurgel; Silva, Bruna Yhang da Costa; Sousa, Paulo Cesar Praciano de; Maia, Sammya Bezerra; Costa, Fabrício da Silva

doi:10.1590/s0100-72032013000800004

Cited by 32 publications

(39 citation statements)

References 28 publications

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“…Bilateral notching has been associated with a 22‐fold increased risk for PE and an almost nine‐fold increased risk for small‐for‐gestational‐age (SGA) neonate; however, it may be observed in around 50% of pregnant women at 11 + 0 to 13 + 6 weeks. This marker therefore has a very low specificity for PE.…”

Section: Screening For Pre‐eclampsia Using Ultrasoundmentioning

confidence: 99%

ISUOG Practice Guidelines: role of ultrasound in screening for and follow‐up of pre‐eclampsia

Sotiriadis

Hernández‐Andrade

Costa

et al. 2018

Ultrasound in Obstet & Gyne

143

115

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RESUMEN Pautas de práctica de ISUOG: la función del ultrasonido en la detección y seguimiento de la preeclampsia Introducción La hipertensión en el embarazo afecta hasta el 10% de las mujeres embarazadas y la incidencia global combinada de la preeclampsia (PE) es de aproximadamente el 3%. Las diferencias significativas entre los países desarrollados y en desarrollo pueden atribuirse a diferencias reales o a diferencias derivadas de la adquisición de datos. La PE y sus complicaciones contribuyen en gran medida a la morbilidad y mortalidad materna y perinatal en todo el mundo. Dado que la atención oportuna y efectiva puede mejorar los resultados de la PE, el desarrollo de estrategias eficaces de predicción y prevención ha sido uno de los principales objetivos de la atención prenatal y de la investigación. La PE es una enfermedad multisistémica de origen multifactorial: está relacionada con placentación defectuosa, estrés oxidativo, autoinmunidad, activación de plaquetas y trombina, inflamación intravascular, disfunción endotelial, desequilibrio en la angiogénesis y mala adaptación cardíaca materna. La invasión defectuosa de la placenta está fuertemente asociada con la mayoría de los casos de PE temprana y grave. En contraste, la placentación defectuosa parece ser menos importante para el desarrollo de la PE que se manifiesta más tarde en el embarazo, por ejemplo después de las 34 semanas. En comparación con los embarazos afectados por la enfermedad de aparición temprana, en aquellos complicados con PE a término o cerca de este, la frecuencia de anomalías histológicas de las placentas es significativamente menor, y los factores maternos (p. ej. el síndrome metabólico o la hipertensión crónica) tienen una importancia relativamente mayor. También se observan diferencias entre la PE de aparición temprana y la de aparición tardía en los factores de riesgo, la capacidad de respuesta vascular materna, el rendimiento del cribado y la eficacia de la prevención. El conocimiento cada vez mayor sobre la fisiopatología de la PE se refleja en las estrategias de cribado actuales, que se basan en el historial, la demografía, los biomarcadores (como la presión arterial) y el Doppler de la arteria uterina. Actualmente hay más de 10 000 artículos de PubMed relacionados con la detección de la PE, lo que indica el gran interés en este tema. Menos de una quinta parte de estos se refieren a la detección temprana, lo que constituye un avance de la última década. El objetivo de estas Pautas es revisar la evidencia más reciente y, en lo posible, proporcionar recomendaciones basadas en la evidencia con respecto a la función del ultrasonido en el cribado y seguimiento de la PE. Las Pautas se centran en los aspectos técnicos y clínicos del cribado, sin incluir los aspectos económicos y políticos de la salud, como la conveniencia y la rentabilidad del cribado. Además, estas Pautas se elaboraron partiendo del supuesto de que se dispone de los recursos necesarios para la realización del cribado y el seguimiento (equipo, examinadores y conocimient...

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Section: Screening For Pre‐eclampsia Using Ultrasoundmentioning

confidence: 99%

ISUOG Practice Guidelines: role of ultrasound in screening for and follow‐up of pre‐eclampsia

Sotiriadis

Hernández‐Andrade

Costa

et al. 2018

Ultrasound in Obstet & Gyne

143

115

View full text Add to dashboard Cite

show abstract

“…When comparing against the models of Gómez et al [20] and Alves et al [21], for these data, Gomez's model yielded an MSE of 0.178, Alves' model yielded an MSE of 0.199 while the derived model within yielded an MSE of 0.163 - some 8.4 and 18.1% lower than the two other models, respectively. The back-transformed centile estimates for the average PI values across the CRL range are presented in supplementary table A.…”

Section: Resultsmentioning

confidence: 87%

“…The substantially lower MSE of the current reference range indicates a superior predictive model. Alves et al [21] published a population-specific reference range for uterine artery PI and resistive index at 11-14 weeks using transabdominal ultrasound in a population from northeast Brazil. The quoted lower (5th) and mean centiles are lower than in this study, which may reflect the different ethnic demographic.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the proportion of measurements falling outside the 90% reference intervals (RIs) was determined and tested against the null hypothesis of the expected 10% using an exact binomial test. The mean squared error (MSE) was used to compare models derived from elsewhere, such as the Poon et al [8] lower PI equation, and the Gómez et al [20] and Alves et al [21] models for average PI values.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Uterine Artery Pulsatility Index Assessment at 11-13<sup>+6</sup> Weeks' Gestation

Ridding

Schluter²,

Hyett³

et al. 2014

Fetal Diagn Ther

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Introduction: First-trimester uterine artery pulsatility index (PI) measurements form part of an algorithm used to assess the risk of developing pre-eclampsia. The objective of this study was to construct a population-specific reference range for both the lower and mean maternal uterine artery PI at 11-13⁺⁶ weeks' gestation and to assess measurement agreement. Materials and Methods: Reference ranges for mean and lower PI measurements were developed using polynomial regression models following prospective collection of maternal uterine artery PI measurements at 11-13⁺⁶ weeks' gestation. Measurement agreement studies were performed by two experienced operators. Results: Measurements from 298 women were included in the primary study. Polynomial regression indicated no change over gestational age for the lower PI (mean 1.44). There was an inverse relationship between the average PI and gestational age (mean [0.8960 + (2.9771 × CRL^-1/2)]²). PI measurement agreement was good-strong (intraclass correlation (ICC) 0.50-0.79) between operators, and within-operator agreement was almost perfect (ICC 0.88-0.93). Conclusions: Reference ranges for both the average and lowest PI of the maternal uterine arteries were derived at 11-13⁺⁶ weeks' gestation. This will provide a basis for development of auditable standards for first-trimester uterine artery Doppler measurements. The PI measurements are reproducible and reliable.

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“…In normal pregnancy the spiral arteries in the placental bed are invaded by trophoblast, which becomes incorporated in the vessel wall and replaces the endothelium, muscular and elastic layers and neural tissues [5]. These physiological changes convert the spiral arteries from narrow muscular vessels to wide non-muscular channels independent of maternal vasomotor control.…”

Section: Discussionmentioning

confidence: 99%

First Trimester Screening for Preeclampsia and Intrauterine Growth Restriction Using Uterine Artery Doppler and Maternal Serum Placental Growth Factor and Pregnancy Associated Plasma Protein- A

Elkholi¹,

Hefeda²,

Nagy³

2016

Reproductive Immunol Open Acc

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Reference range of uterine artery Doppler parameters between the 11th and 14th pregnancy weeks in a population sample from Northeast Brazil

Cited by 32 publications

References 28 publications

ISUOG Practice Guidelines: role of ultrasound in screening for and follow‐up of pre‐eclampsia

ISUOG Practice Guidelines: role of ultrasound in screening for and follow‐up of pre‐eclampsia

Uterine Artery Pulsatility Index Assessment at 11-13<sup>+6</sup> Weeks' Gestation

First Trimester Screening for Preeclampsia and Intrauterine Growth Restriction Using Uterine Artery Doppler and Maternal Serum Placental Growth Factor and Pregnancy Associated Plasma Protein- A

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