Persistence of increased uterine artery resistance in the third trimester and pregnancy outcome

Ghi, T.; Contro, E.; Youssef, A.; Giorgetta, F.; Farina, Antonio; Pilu, Gianluigi; Pelusi, Giuseppe

doi:10.1002/uog.7602

Cited by 40 publications

(44 citation statements)

References 28 publications

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“…Maroni et al [8] found a greater risk of IUGR with elevated uterine PI at 34 weeks, although the risk of late PE was not heightened. In accordance with our observations, Ghi et al [9] reported that persistently elevated UA resistance in the third trimester corresponded with a greater risk of both IUGR and PE and worse perinatal outcomes, accounting for more admissions to neonatal intensive care.…”

Section: Discussionsupporting

confidence: 80%

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Use of Placental Growth Factor and Uterine Artery Doppler Pulsatility Index in Pregnancies Involving Intrauterine Fetal Growth Restriction or Preeclampsia to Predict Perinatal Outcomes

Gómez‐Roig

Mazarico

Sabrià

et al. 2015

Gynecol Obstet Invest

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Aim: The potential of uterine artery (UA) Doppler pulsatility index (PI) and maternal serum placental growth factor (PlGF) level to predict perinatal outcome was explored in pregnancies complicated by intrauterine fetal growth restriction (IUGR) or preeclampsia (PE). Methods: This longitudinal, prospective, and case-controlled study was conducted over a period of 24 months. At-risk pregnancies involving small-for-gestational-age (SGA) fetuses, IUGR, gestational hypertension (GH), or PE were investigated, analyzing UA Doppler PI findings and maternal PlGF levels determined at the time of diagnosis (third trimester). Results: UA Doppler PI and maternal serum PlGF values differed significantly in pregnancies complicated by IUGR and/or PE (vs. SGA or GH, p < 0.01). In the context of IUGR or PE, both parameters also differed significantly by perinatal outcome (adverse vs. normal, p < 0.01), although no predictive advantage over UA Doppler PI alone was conferred by adding a PlGF assay. Conclusion: UA Doppler PI and maternal serum PlGF determinations in the third trimester help identify pregnancies at the highest risk of adverse perinatal outcomes due to IUGR and/or PE. Although joint testing confers no predictive benefit over UA Doppler PI alone, the two diagnostics are interchangeable for this purpose.

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Section: Discussionsupporting

confidence: 80%

“…Accordingly, IUGR and PE are signs of placental decompensation [1]. Uterine artery (UA) Doppler studies reliably detect inadequate placental perfusion in complicated pregnancies (SGA, IUGR, GH, and/or PE conditions), correlating well with maternal/fetal prognosis by the third trimester [2,3,4,5,6,7,8,9,10]. …”

Section: Introductionmentioning

confidence: 99%

Use of Placental Growth Factor and Uterine Artery Doppler Pulsatility Index in Pregnancies Involving Intrauterine Fetal Growth Restriction or Preeclampsia to Predict Perinatal Outcomes

Gómez‐Roig

Mazarico

Sabrià

et al. 2015

Gynecol Obstet Invest

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“…Ghi et al reported the persistence of abnormal Doppler findings at 26-28 weeks was associated with increased risk of pre-eclampsia, SGA and NICU admission [31]. Maroni et al evaluated pregnancy outcome in patients with increased uterine artery PI at 34 weeks' gestation and reported higher chance of delivering SGA babies, but the risk of other complications was not increased [32].…”

Section: Discussionmentioning

confidence: 99%

Multicenter screening for adverse pregnancy outcomes by uterine artery Doppler in the second and third trimester of pregnancy

Jamal¹

2013

Med Ultrason

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Aims: Increased uterine artery pulsatility index (PI) is associated with adverse pregnancy outcomes. The aim of the study was to determine the role of uterine artery PI at 18-24 and 30-34 weeks, gestation in predicting adverse pregnancy outcomes. Material and methods: Color Doppler assessment of the uterine arteries was carried out in 435 consecutive women attending an antenatal clinic at 18-24 weeks and in 134 women at 30-34 weeks. The 95th percentiles of the mean uterine PI and the presence or the absence of bilateral notches was recorded. Using the reference range, performance characteristics in the prediction of pregnancy outcomes were calculated. Association of mean PI at 30-34 weeks with pregnancy outcomes also was studied. The adverse pregnancy outcomes were defined as any or the combination of pre-eclampsia, fetal growth restriction, intrauterine fetal death, preterm delivery and placental abruption. Results: The women with adverse pregnancy outcomes had significant higher mean PI (1.27±0.55 vs. 0.99±0.32; p=0.003) and higher prevalence of bilateral notch (20% vs. 4.6%, p=0.001) than those with normal outcomes. The mean (±SD) PI in women with severe adverse outcome was 1.66±0.66 vs. 1.0±0.32 in women with normal pregnancy outcome (p=0.002). For a screen positive rate of 10.6% (mean PI>95th percentile for gestational age and/or bilateral notches), the sensitivity for predicting an adverse outcome was 33.3%. The sensitivity increased to 60% for predicting a severe adverse outcome. Increased resistance in the third trimester was also associated with an adverse pregnancy outcome Conclusion: Increased uterine artery PI in second and third trimester of pregnancy is associated with an increased risk of adverse pregnancy outcomes.

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“…However, the UtA pulsatility has been shown to be persistently increased until the late-trimester in approximately 30% of the low-risk population, although its association with obstetric complications is unclear [8,10].…”

Section: Introductionmentioning

confidence: 99%

The predictive value of the uterine artery pulsatility index during the early third trimester for the occurrence of adverse pregnancy outcomes depending on the maternal obesity

Kim

Lee

Shin

et al. 2015

Obesity Research & Clinical Practice

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Persistence of increased uterine artery resistance in the third trimester and pregnancy outcome

Abstract: K E Y W O R D S: (20/62 vs. 1/104, P < 0.001 and 20/62 vs. 4/42; P = 0.007, respectively) and admission of the infant to a neonatal intensive care unit (16/62 vs. 4/104; P < 0.001 and 16/62 vs. 1/42; P < 0.001, respectively

Cited by 40 publications

References 28 publications

Use of Placental Growth Factor and Uterine Artery Doppler Pulsatility Index in Pregnancies Involving Intrauterine Fetal Growth Restriction or Preeclampsia to Predict Perinatal Outcomes

Use of Placental Growth Factor and Uterine Artery Doppler Pulsatility Index in Pregnancies Involving Intrauterine Fetal Growth Restriction or Preeclampsia to Predict Perinatal Outcomes

Multicenter screening for adverse pregnancy outcomes by uterine artery Doppler in the second and third trimester of pregnancy

The predictive value of the uterine artery pulsatility index during the early third trimester for the occurrence of adverse pregnancy outcomes depending on the maternal obesity

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