Screening for pre‐eclampsia and fetal growth restriction by uterine artery Doppler and PAPP‐A at 11–14 weeks' gestation

Abstract

Objective To assess the role of maternal demographic characteristics, uterine artery Doppler velocimetry, maternal serum pregnancy-associated plasma protein-A (PAPP-A (OR, 2.0; 95% CI, and low 0.43; 95% CI,. Increased uterine artery PI was the only independent factor in the prediction of placental abruption (OR, 8.49; 95% CI,

Evaluación de la globulina transportadora de hormonas esteroidales (SHBG) durante el embarazo como factor predictor de pre-eclampsia y restricción del crecimiento intrauterino

“…1) El grupo estudiado entre las 11-14 semanas estuvo constituido por 55 pacientes de las cuales se seleccionaron 9 pacientes que desarrollaron PE, 10 • RCIU vs controles.…”

“…Se han propuestos modelos con el fi n de predecir la PE y RCIU en edades gestacionales tempranas, pero por una parte estos presentan un bajo valor predictivo y su implementación es de alto costo económico y, por otra, no aportan intervención profi láctica alguna que permita la prevención o el retraso de la aparición de estas patologías 5,9,10 .…”

Early onset fetal growth restriction

“…pregnancy associasted plasma protein-a, PAPP-A; alfa-fetoprotein, AFP; human chorionic gonadotropin, hCG; Inhibin A) are associated with placental function and fetal growth, and their levels are altered in SGA and FGR pregnancies [56]. A low level first trimester PAPP-A should be considered a major risk factor for delivering a SGA neonate; the combination of uterine artery Doppler and maternal serum markers appears promising for improving prediction of SGA fetus, although predictive values are still poor [57][58][59]. Use of combination testing in the second trimester appears to predict adverse outcome related to placental insufficiency more effectively than first trimester screening [60].…”

The role of ultrasound in the diagnosis and management of the growth restricted fetus

“…Pilalis, et al . have reported that the predictive value of first trimester uterine artery Doppler results can be improved with the addition of maternal serum PAPP‐A, suggesting that both markers in combination may be better than either alone 18 . If the predictive value of single or combination markers in the first trimester can be improved, then therapeutic initiatives are more likely to be successful.…”