Second‐trimester fetal growth as a predictor of poor obstetric and neonatal outcome in patients with low first‐trimester serum pregnancy‐associated plasma protein‐A and a euploid fetus

Abstract

K E Y W O R D S:

Predictive values of maternal serum PAPP-A level, uterine artery Doppler velocimetry, and fetal biometric measurements for poor pregnancy and poor neonatal outcomes in pregnant women

“…-14 th weeks of pregnancy may be beneficial in predicting poor pregnancy and poor neonatal outcomes and in taking necessary measures (12,13). The present study aimed to determine the predictive value of maternal serum PAPP-A levels measured in the first trimester, uterine artery Doppler velocimetry performed during the second trimester, and FBMs in the second and third trimesters for poor pregnancy and poor neonatal outcomes in pregnant women.…”

“…This high-risk group was compared with the other group of pregnant women and statistically significant differences were determined in terms of pregnancy outcomes (p=0.045) and mean birth weight (p=0.011). In the literature, studies on this subject are not so many, excluding two separate studies conducted by Fox et al (12,13) suggesting an association between a HC/AC ratio >90 th percentile and poor pregnancy outcomes and the study conducted by Colley et al (23) determining a weak correlation between the HC/AC ratio and the ponderal index. In addition to the literature information, the present study indicated that it is possible to obtain significant results in terms of pregnancy outcomes and birth weight in the light of precise FBMs and an assessment of the HC/AC ratio (23,24).…”

“…All the ultrasonographic measurements were performed by the same physician, using color Doppler ultrasound (Voluson 730 Expert, General Electric Healthcare; Chicago, USA) and the data were assessed by a single researcher. Pregnant women were considered to be under risk of early-onset IUGR when the estimated gestational age according to the ultrasonographic FBMs at the 20 (12,13). This group was compared with the group of pregnant women in whom the estimated gestational age according to the FBMs was consistent with the gestational age calculated according to the LMP, with respect to the test results as well as pregnancy outcomes, including the birth weight.…”

Low PAPP‐A: the impact of ultrasound to evaluate fetal growth

“…The pathophysiology of obstetric complications associated with low PAPP-A involves abnormal placental function, and lesions associated with malperfusion are more prevalent in affected pregnancies. [7][8][9] Histologically, low PAPP-A appears to be associated with defective syncytiotrophoblast formation and function. 10 In addition to growth restriction, low PAPP-A has also been associated with stillbirth, preeclampsia, abruptio placenta, and preterm birth.…”

Adverse Pregnancy Outcomes After Abnormal First-Trimester Screening for Aneuploidy

“…Fox et al92 reported that 10.5% of women with PAPP-A<5th%ile have evidence of fetal growth disturbances defined as: a) estimated fetal weight <25%ile b) a greater than 7 day growth discrepancy with established dates or c) a measurement of >90th%ile for head or abdominal circumference. In this group, the rate of birth weight <10th%ile was 47.8% and the rate of birth weight<5th%ile was 21.7%.…”