Evaluation of third trimester uterine artery flow velocity indices in relationship to perinatal complications

Ghosh, Gisela; Bręborowicz, Andrzej; Brązert, Maciej; Maczkiewicz, M; Kobelski, Mikołaj; Dubiel, Mariusz; Gudmundsson, Sæmundur

doi:10.1080/14767050600852510

Cited by 29 publications

(22 citation statements)

References 16 publications

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“…Becker and Vonk [3] found that deep notching in the uterine arteries at 20 -23 weeks was associated with adverse pregnancy outcome. In contrast, Ghosh et al [12] suggested that the uteroplacental vascular impedance was a better predictor than the presence of notching in the third trimester for adverse outcome of SGA suspected pregnancies. Furthermore, we did not record the rate of labor induction in our study population.…”

Section: Discussionmentioning

confidence: 88%

Value of Doppler sonography near term: can umbilical and uterine artery indices in low-risk pregnancies predict perinatal outcome?

Bolz

Kalache²,

Proquitté³

et al. 2012

Journal of Perinatal Medicine

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Section: Discussionmentioning

confidence: 88%

Value of Doppler sonography near term: can umbilical and uterine artery indices in low-risk pregnancies predict perinatal outcome?

Bolz

Kalache²,

Proquitté³

et al. 2012

Journal of Perinatal Medicine

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“…15 This is in contrast to the findings of Ghosh et al where RI and PI were considered better indicators of vascular impedance in predicting adverse perinatal outcomes. 16 B/L notch in uterine artery Doppler was present in 25.4% participants and this findings are quit comparable with the similar study done by Wald RM et al, Rai L et al but not consistent with study done by Maria AL et al and Li H et al 11,13,14,17 Study found acceptable sensitivity, specificity, PPV and NPV of Doppler ultrasound during third trimester to predict obstetrical and perinatal outcome and this findings are comparable with study done by Rai L et al 13 Limitations of this study was number of cases has been small and study not included Patients who came in labor or with a complication like abruptio placenta.…”

Section: Discussionmentioning

confidence: 99%

Third trimester Doppler ultrasound as prediction of obstetric outcome in high-risk pregnancy, Gujarat, India

Ghosh

Oza

Meel

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Doppler ultrasound has emerged as beneficial tool in the assessment of the fetal and placental circulation and in the prediction of adverse pregnancy outcome. Umbilical artery Doppler has proved helpful to supervise the growth restricted fetuses and compromised vasculature as in hypertensive disorders high risk pregnancies. Objective of present study was to investigate the association between third-trimester uterine artery Doppler assessment and adverse obstetric outcome.Methods: This prospective study was done among 110 high risk pregnancies. Vessel like uterine artery, umbilical artery, middle cerebral artery and ductus venosus were studied in present study. Indices calculated: Peak systolic velocity, End diastolic velocity, Mean velocity, Systolic/diastolic ratio, Pulsatility index (PI) and resistance index (RI) of middle cerebral artery (MCA), Ductus venosus S/A ratio.Results: bilateral notch was present statistically significant (p<0.05) in 18.1% and absent in 28.2% among cases of adverse perinatal outcome. UA S/D ratio was >3 in 22.7% and <3 in 11.8% among cases of adverse perinatal outcome and findings were statistically significant (p<0.05). End diastolic velocity was reduced in statistically significant (p<0.05) in 9.1% and normal in 20.1% among cases of adverse perinatal outcome. MCA PI was <lower limit statistically significant (p<0.05) in 24.5% and >lower limit in 18.2% among cases of adverse perinatal outcome. MCA PI/UA PI ratio was <1 statistically significant (p<0.05) in 25.5% and absent in 17.3% among cases of adverse perinatal outcome.Conclusions: Increase in UA PI and decrease in MCA PI are early marker for detection of fetal compromise. Ratio of indices between MCA PI and UA PI reflects brain sparing effect as well as placental insufficiency and these are more specific in detection of IUGR than individual artery indices.

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“…These babies are at increased risk of preterm birth (30,31). Moreover, there is controversy surrounding the risk of respiratory distress syndrome (RDS) in this obstetric subgroup (12), which may be in part attributable to the heterogeneous causes of IUGR (maternal, fetal, and/or placental factors; reviewed in Refs.…”

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confidence: 99%

Increased lung prolyl hydroxylase and decreased glucocorticoid receptor are related to decreased surfactant protein in the growth-restricted sheep fetus

Orgeig

McGillick

Botting

et al. 2015

American Journal of Physiology-Lung Cellular and Molecular Phys

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Experimental placental restriction (PR) by carunclectomy in fetal sheep results in intrauterine growth restriction (IUGR), chronic hypoxemia, increased plasma cortisol, and decreased lung surfactant protein (SP) expression. The mechanisms responsible for decreased SP expression are unknown but may involve decreased glucocorticoid (GC) action or changes in hypoxia signaling. Endometrial caruncles were removed from nonpregnant ewes to induce PR. Lungs were collected from control and PR fetuses at 130-135 (n = 19) and 139-145 (n = 28) days of gestation. qRT-PCR and Western blotting were used to quantify lung mRNA and protein expression, respectively, of molecular regulators and downstream targets of the GC and hypoxia-signaling pathways. We confirmed a decrease in SP-A, -B, and -C, but not SP-D, mRNA expression in PR fetuses at both ages. There was a net downregulation of GC signaling with a reduction in GC receptor (GR)-α and -β protein expression and a decrease in the cofactor, GATA-6. GC-responsive genes including transforming growth factor-β1, IL-1β, and β2-adrenergic receptor were not stimulated. Prolyl hydroxylase domain (PHD)2 mRNA and protein and PHD3 mRNA expression increased with a concomitant increase in hypoxia-inducible factor-1α (HIF-1α) and HIF-1β mRNA expression. There was an increase in mRNA expression of several, but not all, hypoxia-responsive genes. Hence, both GC and hypoxia signaling may contribute to reduced SP expression. Although acute hypoxia normally inactivates PHDs, chronic hypoxemia in the PR fetus increased PHD abundance, which normally prevents HIF signaling. This may represent a mechanism by which chronic hypoxemia contributes to the decrease in SP production in the IUGR fetal lung.

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Evaluation of third trimester uterine artery flow velocity indices in relationship to perinatal complications

Abstract: RI and PI as measures of third trimester utero-placental vascular impedance are the best predictors of adverse outcome of IUGR-suspected pregnancies.

Cited by 29 publications

References 16 publications

Value of Doppler sonography near term: can umbilical and uterine artery indices in low-risk pregnancies predict perinatal outcome?

Value of Doppler sonography near term: can umbilical and uterine artery indices in low-risk pregnancies predict perinatal outcome?

Third trimester Doppler ultrasound as prediction of obstetric outcome in high-risk pregnancy, Gujarat, India

Increased lung prolyl hydroxylase and decreased glucocorticoid receptor are related to decreased surfactant protein in the growth-restricted sheep fetus

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