A Review of Roles of Uterine Artery Doppler in Pregnancy Complications

Tian, Yingying; Yang, Xiuhua

doi:10.3389/fmed.2022.813343

Cited by 17 publications

(17 citation statements)

References 149 publications

(240 reference statements)

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“…Te kinetic parameters will decrease accordingly. Studies have shown that uterine artery hemodynamic parameters in patients with preeclampsia are signifcantly higher than those in normal pregnant women [19]. Ultrasound technology enables the noninvasive and real-time assessment of hemodynamic parameters in vital organs of pregnant women and fetuses [20].…”

Section: Introductionmentioning

confidence: 99%

[Retracted] Clinical Value of Serum SIRT1 Combined with Uterine Hemodynamics in Predicting Disease Severity and Fetal Growth Restriction in Preeclampsia

Kong

2023

Evidence-Based Complementary and Alternative Medicine

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Objective. The sirtuin regulator 1-related enzyme (SIRT1) has been shown to play an important role in various pathophysiological processes. Our aim was to investigate the effect and correlation of serum SIRT1 combined with uterine hemodynamic parameters on disease severity and fetal uterine growth restriction in the progression of preeclampsia and to evaluate its clinical value as a potential marker. Methods. A total of 100 patients with preeclampsia who were hospitalized in Qufu Normal University Hospital from June 2017 to June 2021 were selected as the research objects. According to the severity, they were divided into the mild (62 cases) and severe groups (38 cases), and according to whether the fetal growth restriction was combined or not, they were divided into the combined fetal growth restriction group (56 cases) and the uncomplicated fetal growth restriction group (44 cases). Serum SIRT1 expression and uterine artery hemodynamic parameters were detected, and Spearman analysis was used to evaluate the association of serum SIRT1 expression and uterine artery hemodynamic parameters (the peak-to-trough ratio of arterial blood velocity, the pulsatility index, and the resistance index) with disease severity (systolic blood pressure, diastolic blood pressure, and random urinary protein levels) and fetal growth restriction (femoral length, biparietal diameter, head circumference, and neonatal weight); unsupervised principal component analysis (PCA), supervised partial least-squares discrimination analysis (PLS-DA), cluster heat map analysis, the receiver operating characteristic (ROC) curve, and the area under curve (AUC) were used to evaluate the diagnostic value of serum SIRT1 expression combined with uterine artery hemodynamic parameters in the severity of disease and fetal growth restriction in patients with preeclampsia. Results. Compared with patients with mild preeclampsia, serum SIRT1 expression was lower in patients with severe preeclampsia ( p < 0.0001 ), the arterial blood flow velocity peak-to-trough ratio, pulsatility index, and resistance index were higher ( p < 0.001 ; p < 0.0001 ); and serum SIRT1 expression and uterine artery hemodynamic parameters were closely related to disease severity ( p < 0.001 ; p < 0.0001 ). In addition, the expression of serum SIRT1 in patients with preeclampsia combined with fetal growth restriction was lower than patients without preeclampsia ( p < 0.0001 ); the peak-to-trough ratio of arterial blood flow velocity, the pulsatility index, and the resistance index were higher ( p < 0.0001 ); and serum SIRT1 expression and uterine artery hemodynamics were closely related to fetal growth restriction ( p < 0.0001 ). Unsupervised PCA analysis and supervised PLS-DA analysis showed that patients with different severity of disease and patients with or without fetal growth restriction were similar within the groups, and there were significant differences between the groups; cluster heat map analysis showed that the mild and severe groups were stratified clustering, and the combined fetal growth restriction group and the uncombined group were hierarchically clustered; ROC curve showed that the AUC of serum SIRT1 expression combined with uterine artery hemodynamic parameters was 0.776 in identifying the severity of preeclampsia and 0.956 in identifying the preeclampsia complicated by fetal growth restriction. Conclusion. Serum SIRT1 combined with uterine hemodynamic parameters in preeclampsia is closely related to disease severity and fetal growth restriction and is expected to become a potential biomarker for early clinical intervention in patients.

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Section: Introductionmentioning

confidence: 99%

[Retracted] Clinical Value of Serum SIRT1 Combined with Uterine Hemodynamics in Predicting Disease Severity and Fetal Growth Restriction in Preeclampsia

Kong

2023

Evidence-Based Complementary and Alternative Medicine

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“…PE can be predicted with more accuracy in the second trimester of conception by the use of Uterine Artery Doppler study than in the first, according to research on the subject. It also played a significant part in foretelling severe or early-onset PE in lowrisk populations [30] . Doppler studies of the uterine artery may be more predictive of PE if measured repeatedly in the first half of conception, according to research, which also found that using the firsttrimester uterine artery Doppler in PE anticipation had an overall sensitivity of 26% and specificity of 91%.…”

Section: Discussionmentioning

confidence: 99%

First trimester screening and prediction of preeclampsia by Application of Fetal Medicine Foundation Algorithm at Tanta University

Ismail¹,

Hamamy²,

Abdallah³

et al. 2023

Int. J. Clin. Obstet. Gynaecol.

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Background: Preeclampsia (PE) is a complex illness linked to conception that affects a variety of bodily functions and is usually connected with perinatal morbidity and deaths. Early PE anticipation will reduce this linked morbidity and death by allowing for routine maternal and foetal monitoring and the use of preventative measures. Aim of the work: the goal of this study is to investigate whether the measurement of maternal serum placental growth factor (PlGF) combined with uterine artery Doppler ultrasound, are useful in early predicting PE and to examine the diagnostic accuracy of the Fetal Medicine Foundation (FMF) Algorithm for the early screening and anticipation of the high-risk PE at 11-13 weeks conception in a group of pregnant women. Patients and Methods: one hundred and twenty primigravida women with living, singleton fetus at 11-13 weeks conception without risk factors other than being primigravida attending antenatal care clinic at the Department of Obstetrics and Gynecology at Tanta University Hospitals. All cases were subjected to ; A signed informed written consent, proper history taking, full clinical examination, estimation of body mass index (BMI), blood pressures and determination of mean arterial blood pressure (MAP), ultrasound, Uterine artery doppler ultrasound examination with the determination of the mean Pulsatility index (PI) of the uterine arteries. Maternal serum levels of PlGF were also measured by specific immunoassay (ELISA). The measured values of MAP, mean uterine artery pulsatility index (PI) and PlGF were converted into multiples of the median (MoM). Then the FMF model was used for the determination of patient-specific risk of PE at 11-13 weeks conception in each case. Results:The main results of the present study revealed that; Only 11 of 120 normal pregnant women were categorized as a high PE risk with a percentage of 9.2% and the rest 109 cases were low PE risk with a percentage of 90.8% by application of FMF algorithm. There was a significant difference between the high and low risks regarding the mean uterian UtA-Pi and PIGF levels at 11-13 weeks. Receiver operating characteristic curve (ROC) demonstrate to what extent it can be depended on PlGF, mean UtA-PI and MAP as a predictor for PE denoting the significant diagnostic performance for PIGF and mean uterine artery pulsatility index (PI). The optimal cutoff value of PlGF value using the ROC curve was ≤40 leading to a sensitivity of 90.91%, a specificity of 96.33%, a PPV of 71.4, a NPV of 99.1% and an accuracy of 95.83%. While the optimal cutoff measure of mean uterine artery PI value using the ROC curve was >1.91 leading to a sensitivity of 90.91%, a specificity of 96.33%, PPV of 71.4, NPV of 99.1% and an accuracy of 95.83%. Conclusion:On the basis of these results, it could be concluded that the combined measurement of maternal serum PlGF concentrations and mean PI of the uterine arteries at 11-13 weeks of conception may help to predict the high-risk PE in primigravida when other parameters of PE anticipation are norm...

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“…Many authors have indicated that it is possible to predict significant vascular events during pregnancy through uterine artery Doppler examination. [27] High maternal BMI might decrease the uterine artery pulsatility index (UtA-PI). [28] The UtA-PI of the placental side is lower than that of the non-placental side.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of diabetes in pregnancy with stillbirth

et al. 2023

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We analyzed the clinical characteristics of patients with diabetes in pregnancy (DIP) associated with stillbirth and explored strategies to reduce its incidence. We retrospectively analyzed 71 stillbirths associated with DIP (group A) and 150 normal pregnancies (group B) during 2009 to 2018. The incidence of the following was higher in group A (P < .05): hypertensive disorders (38.03% vs 6.00%), placenta previa (14.08% vs 2.67%), placental abruption (5.63% vs 0.67%), fetal malformation (8.45% vs 0.67%), fasting plasma glucose (FPG) ≥ 7.0 mmol/L (46.48% vs 0.67%), 2-h postprandial plasma glucose ≥ 11.1 mmol/L (57.75% vs 6.00%), HbA1c ≥ 6.5% (63.38% vs 6.00%), and polyhydramnios (11.27% vs 4.67). The incidence of oligohydramnios (4.23% vs 6.67%) was lower in group A than in group B (P < .05). According to the gestational age at the time of stillbirth, Group-A cases were subgrouped into miscarriages (20-27 +6 weeks), premature deliveries (28-36 +6 weeks), and full-term deliveries (≥37 weeks). Age, parity, and DIP type did not differ among the subgroups (P > .05). Among patients with DIP, antenatal FPG, 2-h postprandial plasma glucose, and HbA1c were significantly associated with stillbirth (P < .05). Stillbirth was first detected at 22 weeks and typically occurred at 28-36 +6 weeks. DIP was associated with a higher incidence of stillbirth, and FPG, 2-h postprandial plasma glucose, and HbA1c were potential indicators of stillbirth in DIP. Age (odds ratio [OR]: 2.21, 95% confidence interval [CI]: 1.67-2.74), gestational hypertension (OR: 3.44, 95% CI: 2.21-4.67), body mass index (OR: 2.86, 95% CI: 1.95-3.76), preeclampsia (OR: 2.29, 95% CI: 1.45-3.12), and diabetic ketoacidosis (OR: 3.99, 95% CI: 1.22-6.76) were positively correlated with the occurrence of stillbirth in DIP. Controlling perinatal plasma glucose, accurately detecting and managing comorbidities/ complications, and timely termination of pregnancy can reduce the incidence of stillbirths associated with DIP.Abbreviations: BMI = body mass index, CI = confidence interval, DIP = diabetes in pregnancy, FGR = fetal growth restriction, FPG = fasting plasma glucose, GDM = gestational diabetes mellitus, HbA1c = glycohemoglobin, OR = odds ratio, PGDM = pregestational diabetes mellitus.

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A Review of Roles of Uterine Artery Doppler in Pregnancy Complications

Cited by 17 publications

References 149 publications

[Retracted] Clinical Value of Serum SIRT1 Combined with Uterine Hemodynamics in Predicting Disease Severity and Fetal Growth Restriction in Preeclampsia

[Retracted] Clinical Value of Serum SIRT1 Combined with Uterine Hemodynamics in Predicting Disease Severity and Fetal Growth Restriction in Preeclampsia

First trimester screening and prediction of preeclampsia by Application of Fetal Medicine Foundation Algorithm at Tanta University

Clinical analysis of diabetes in pregnancy with stillbirth

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