The association of first trimester uterine arteries Doppler velocimetry with different clinical phenotypes of hypertensive disorders of pregnancy: a longitudinal study

Stampalija, Tamara; Monasta, Lorenzo; Martino, Daniela Di; Quadrifoglio, Mariachiara; Bello, Leila Lo; D’Ottavio, G.; Zullino, Sara; Mastroianni, C.; Casati, D.; Signorelli, V.; Rosti, E.; Cecotti, Vera; Ceccarello, Matteo; Ferrazzi, E.

doi:10.1080/14767058.2017.1402878

Cited by 12 publications

(15 citation statements)

References 25 publications

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“…Specifically, low maternal cardiac output and high maternal peripheral vascular resistance are associated with raised impedance in the maternal uterine and fetal umbilical arteries. 36 Interestingly, there was no relationship with fetal cerebral Doppler impedance that indicated that the mechanism is unlikely to be mediated by hypoxia.…”

Section: Commentmentioning

confidence: 97%

Uterine and fetal placental Doppler indices are associated with maternal cardiovascular function

Tay

Masini

McEniery

et al. 2019

American Journal of Obstetrics and Gynecology

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Uterine artery Doppler change is abnormally elevated in fetal growth restriction with and without preeclampsia, but not in preeclampsia, which may explain the limited sensitivity of uterine artery Doppler changes for all these complications when considered in aggregate. Furthermore, impedance within fetoplacental arterial vessels is at least, in part, associated with maternal cardiovascular function. This relationship may have important implications for fetal surveillance and would inform therapeutic options in those pathologic pregnancy conditions currently, and perhaps erroneously, attributed purely to placental maldevelopment. Uterine and fetal placental Doppler indices are associated significantly with maternal cardiovascular function. The classic description of uterine and fetal Doppler changes being initiated by placental maldevelopment is a less plausible explanation for the pathogenesis of the conditions than that relating to maternal cardiovascular changes.

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Section: Commentmentioning

confidence: 97%

Uterine and fetal placental Doppler indices are associated with maternal cardiovascular function

Tay

Masini

McEniery

et al. 2019

American Journal of Obstetrics and Gynecology

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“…In normal pregnancy, uterine artery pulsatility index (UtA-PI) decreases with advancing gestation 1,2 . In hypertensive disorders of pregnancy (HDP), UtA-PI is higher than in normal pregnancy from as early as the first trimester; this difference persists throughout pregnancy, although the PI still decreases with advancing gestation 1,[3][4][5] . This difference is most apparent in early-onset HDP associated with fetal growth restriction (FGR) 1,[3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

“…In hypertensive disorders of pregnancy (HDP), UtA-PI is higher than in normal pregnancy from as early as the first trimester; this difference persists throughout pregnancy, although the PI still decreases with advancing gestation 1,[3][4][5] . This difference is most apparent in early-onset HDP associated with fetal growth restriction (FGR) 1,[3][4][5] . High early-pregnancy UtA-PI has been attributed to impaired trophoblast invasion and poor spiral artery remodeling in pregnancies prone to HDP [6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Correlation between central and uterine hemodynamics in hypertensive disorders of pregnancy

Perry

Lehmann

Mantovani

et al. 2019

Ultrasound in Obstet & Gyne

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Differences observed in the uterine artery resistance in the third trimester of pregnancy are mirrored in the central maternal haemodynamic parameters. Late pregnancy differences in the utero-placental circulation in preterm and term HDP are an index of maternal cardiovascular function rather than being related to inadequate spiral artery modelling and impaired placentation. This article is protected by copyright. All rights reserved.

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“…This dualistic view of the pathogenesis of PE is important for both clinical and research reasons, but, not surprisingly, some risk factors or pathogenetic aspects can overlap. 14,15 Major challenges in modern obstetrics is the prediction of women at high risk of PE early in the first trimester. 14,15 Since the trophoblastic invasion and the consequent inflammatory reaction are among the earliest events in pregnancy, one could speculate that inflammation mediators might constitute adequate predictors.…”

Section: Introductionmentioning

confidence: 99%

“…14,15 Major challenges in modern obstetrics is the prediction of women at high risk of PE early in the first trimester. 14,15 Since the trophoblastic invasion and the consequent inflammatory reaction are among the earliest events in pregnancy, one could speculate that inflammation mediators might constitute adequate predictors. However, on the one hand, the selective dosage of a single cytokine lacks in specificity, and, on the other hand, the precise quantification of reactive oxygen species (ROS) is difficult.…”

Section: Introductionmentioning

confidence: 99%

Mitochondrial DNA Copy Number in Peripheral Blood in the First Trimester of Pregnancy and Different Preeclampsia Clinical Phenotypes Development: A Pilot Study

et al. 2018

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Inflammation and oxidative stress are intrinsically linked to early poor placentation, typical of pregnancies complicated by preeclampsia associated with intrauterine growth restriction (PE-IUGR). Low mitochondrial DNA copy number (mtDNAcn) in peripheral blood constitutes a good peripheral surrogate marker of inflammation and oxidative stress. On these basis, we explored a possible correlation between mtDNAcn in peripheral blood in the first trimester of pregnancy and the PE-IUGR onset. To shed light on this issue, we setup a nested case–control study from a prospective cohort of pregnant women undergoing first-trimester aneuploidies screening. Two groups of patients affected by PE classified according to the clinical phenotype were identified: (1) patients who developed PE-IUGR and (2) patients who developed PE associated with appropriate for gestational age intrauterine fetal growth (PE-AGAf). Controls were women with a physiologic pregnancy matched to cases on the basis of age (±6 months, ratio 2:1). Mitochondrial DNA copy number was quantified using real-time polymerase chain reaction and normalized to nuclear DNA. The median (interquartile range) mtDNAcn in peripheral blood in patients with PE-IUGR (n = 12) and in patients with PE-AGAf (n = 16) was 70 (44-97) and 108 (95-145), respectively ( P = .004). Both these values were significantly lower than that detected in the control group (161[133-183], P < .001). The area under the receiver–operator curve for PE-IUGR and PE-AGAf were 0.94 (95% confidence interval [CI]: 0.88-1.00, P < .001) and 0.81 (95%CI: 0.70-0.91, P < .001), respectively. In conclusion, MtDNAcn in peripheral blood resulted significantly lower both in patients affected by PE-IUGR and in those affected by PE-AGAf when compared to controls. The accuracy of this biomarker resulted particularly good in predicting PE-IUGR.

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The association of first trimester uterine arteries Doppler velocimetry with different clinical phenotypes of hypertensive disorders of pregnancy: a longitudinal study

Cited by 12 publications

References 25 publications

Uterine and fetal placental Doppler indices are associated with maternal cardiovascular function

Uterine and fetal placental Doppler indices are associated with maternal cardiovascular function

Correlation between central and uterine hemodynamics in hypertensive disorders of pregnancy

Mitochondrial DNA Copy Number in Peripheral Blood in the First Trimester of Pregnancy and Different Preeclampsia Clinical Phenotypes Development: A Pilot Study

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