Identification of patients at risk for early onset and/or severe preeclampsia with the use of uterine artery Doppler velocimetry and placental growth factor

Espinoza, Jimmy; Romero, Roberto; Nien, Jyh Kae; Gomez, Ricardo; Kusanovic, Juan Pedro; Gonçalves, Luís F.; Medina, Lorena; Edwin, Sam; Hassan, Sonia S.; Carstens, Mario; González, Rogelio

doi:10.1016/j.ajog.2006.11.002

Cited by 234 publications

(161 citation statements)

References 79 publications

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“…An abnormal uterine artery Doppler velocimetry result between 22 and 26 weeks of gestation is considered to be a surrogate marker of chronic uteroplacental ischemia [4].…”

Section: Introductionmentioning

confidence: 99%

Prediction of Pre-Eclampsia by a Combination of Maternal History, Uterine Artery Doppler, and Mean Arterial Pressure (A Prospective Study of 200 Cases)

Prajapati

Maitra

2012

J Obstet Gynecol India

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Objective To determine the clinical value of uterine artery Doppler Pulsatility index (PI) at 22-24 ? 6 weeks scan and importance of maternal history and mean arterial pressure (MAP) in the prediction of pre-eclampsia. Materials and Methods This was a prospective screening study of 200 women with singleton pregnancy. Maternal history and blood pressure were recorded, and MAP was calculated. Transabdominal Doppler ultrasound of uterine artery was performed. Mean PI was calculated, and the presence or the absence of bilateral early diastolic notch was noted. Women were then followed up through pregnancy and delivery for the development of pre-eclampsia, gestational hypertension, and SGA. Results The mean ± SD PI value for subjects who had an adverse pregnancy outcome was significantly higher (0.84 ± 0.28) than mean ± SD PI value for subjects who had normal pregnancy outcome (0.71 ± 0.16) with P value \0.000. Conclusion Second trimester uterine artery Doppler is a useful screening method for identification of high risk pregnancy in women who can be kept under close surveillance for better maternal and neonatal outcome. This test works better when combined with previous history of pre-eclampsia and MAP.

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“…An abnormal uterine artery Doppler velocimetry result between 22 and 26 weeks of gestation is considered to be a surrogate marker of chronic uteroplacental ischemia [4].…”

Section: Introductionmentioning

confidence: 99%

Prediction of Pre-Eclampsia by a Combination of Maternal History, Uterine Artery Doppler, and Mean Arterial Pressure (A Prospective Study of 200 Cases)

Prajapati

Maitra

2012

J Obstet Gynecol India

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“…Indeed, several studies have addressed this issue using a single analyte or a combination of analytes with the results of uterine artery Doppler velocimetry [24,[33][34][35][36], as well as clinical risk factors. These studies have largely focused on one determination of the plasma/serum concentrations of angiogenic and/or anti-angiogenic factors.…”

mentioning

confidence: 99%

The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age

Erez

Romero

Espinoza

et al. 2008

The Journal of Maternal-Fetal & Neonatal Medicine

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The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age, The Journal of Maternal-Fetal & Neonatal Medicine, 21:5, 279-287, DOI: 10.1080 AbstractIntroduction. An imbalance between angiogenic and anti-angiogenic factors has been proposed as central to the pathophysiology of preeclampsia (PE). Indeed, patients with PE and those delivering small-for-gestational age (SGA) neonates have higher plasma concentrations of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and the soluble form of endoglin (s-Eng), as well as lower plasma concentrations of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) than do patients with normal pregnancies. Of note, this imbalance has been observed before the clinical presentation of PE or the delivery of an SGA neonate. The objective of this study was to determine if changes in the profile of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters are associated with a high risk for the subsequent development of PE and/or delivery of an SGA neonate. Methods. This longitudinal case-control study included 402 singleton pregnancies in the following groups: (1) normal pregnancies with appropriate for gestational age (AGA) neonates (n ¼ 201); (2) patients who delivered an SGA neonate (n ¼ 145); and (3) patients who developed PE (n ¼ 56). Maternal plasma samples were obtained at the time of each prenatal visit, scheduled at 4-week intervals from the first or early second trimester until delivery. In this study, we included two samples per patient: (1) first sample obtained between 6 and 15 weeks of gestation ('first trimester' sample), and (2) second sample obtained between 20 and 25 weeks of gestation ('second trimester' sample). Plasma concentrations of s-Eng, sVEGFR-1, and PlGF were determined by specific and sensitive immunoassays. Changes in the maternal plasma concentrations of these angiogenesis-related factors were compared among normal patients and those destined to develop PE or deliver an SGA neonate while adjusting for maternal age, nulliparity, and body mass index. General linear models and polytomous logistic regression models were used to relate the analyte concentrations, ratios, and product to the subsequent development of PE and SGA. Results.(1) An increase in the maternal plasma concentration of s-Eng between the first and second trimesters conferred risk for the development of preterm PE and SGA (OR 14.9, 95% CI 4.9-45.0 and OR 2.9, 95% CI 1.5-5.6, respectively).(2) An increase in the maternal plasma concentration of sVEGFR-1 between the first and second trimester conferred risk for the development of preterm PE (OR 3.9, 95% CI 1.2-12.6). (3) A subnormal increase in maternal plasma PlGF concentration between the first and the second trimester was a risk factor for the subsequent development of preterm and term PE (OR 4....

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“…(2) Does the combination of angiogenic and anti-angiogenic factor concentration add information to that already provided by uterine artery Doppler velocimetry in the midtrimester of pregnancy? There are already hints that this is the case [88]. (3) Can an antiangiogenic state in pregnancy be treated with the administration of angiogenic factors?…”

Section: Open Questionsmentioning

confidence: 99%

The role of an ‘anti-angiogenic state’ in complications of pregnancy

Renzo

2008

The Journal of Maternal-Fetal & Neonatal Medicine

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Identification of patients at risk for early onset and/or severe preeclampsia with the use of uterine artery Doppler velocimetry and placental growth factor

Cited by 234 publications

References 79 publications

Prediction of Pre-Eclampsia by a Combination of Maternal History, Uterine Artery Doppler, and Mean Arterial Pressure (A Prospective Study of 200 Cases)

Prediction of Pre-Eclampsia by a Combination of Maternal History, Uterine Artery Doppler, and Mean Arterial Pressure (A Prospective Study of 200 Cases)

The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age

The role of an ‘anti-angiogenic state’ in complications of pregnancy

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