Predicting Risks of Preeclampsia and Small for Gestational Age Infant by Uterine Artery Doppler

Phupong, Vorapong; Dejthevaporn, Thewin

doi:10.1080/10641950801958059

Cited by 15 publications

(8 citation statements)

References 26 publications

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“…Numerous studies have shown that late first trimester screening of the uterine artery in high-risk women can accurately identify a subset of women who are destined for major complications that will be attributable to placental disease. Serial Doppler assessment of the uterine artery is performed from the 16th wk onwards in these high risk women who may have history of factors known to cause IUGR 25,26 . The persistence of the pre-diastolic notch and gradually increasing impedance indices suggest an abnormal uterine circulation and hence is an indicator to treat these women with bed rest, antihypertensives and oxygen therapy right from the onset of the pathology.…”

Section: Changing Trends In Doppler Assessment Of Iugr Fetusesmentioning

confidence: 99%

Colour Doppler in IUGR- Where are we and where do we go?

Lulla

Garg

2010

J Obstet Gynecol India

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Intra-uterine growth restriction (IUGR) is an important perinatal problem giving rise to increased morbidity and mortality in the growth restricted fetus. The aim of fetal medicine today, is to prevent the mere occurrence of IUGR in high risk pregnancies and to deliver the fetuses already afflicted with growth restriction, before they have suffered from the effects of hypoxia. The use of Doppler provides this information, which is not readily obtained from the other conventional tests of fetal well being. The Doppler patterns follow a longitudinal trend in the arterial and venous circulation of the fetus as well as the placental vasculature guiding management decisions regarding the appropriate time of delivery. Progressive knowledge of the fetal circulation and its adaptation when the fetus is subjected to hypoxia, has helped us recognize the early signs of IUGR thereby improving the prognosis of these complicated pregnancies. It has therefore become the gold standard in the management of the growth-restricted fetus.

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Section: Changing Trends In Doppler Assessment Of Iugr Fetusesmentioning

confidence: 99%

Colour Doppler in IUGR- Where are we and where do we go?

Lulla

Garg

2010

J Obstet Gynecol India

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“…This model can be evaluated by uterine artery Doppler. 11 Many studies on uterine artery Doppler have demonstrated that preeclamptic patients have more abnormal uterine artery Doppler findings than normal patients. In systematic reviews and meta-analyses, it has been suggested that the presence of a uterine artery notch or an increase of uterine artery pulsatility index (PI) are better predictors of preeclampsia in the second trimester than in the first trimester (sensitivity 77-96%).…”

Section: Introductionmentioning

confidence: 99%

Combination of plasma-soluble fms-like tyrosine kinase 1 and uterine artery Doppler for the prediction of preeclampsia in cases of elderly gravida

Kulmala

Phupong

2014

Hypertens Res

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The aim of this study was to determine the predictive value of the combination of plasma-soluble fms-like tyrosine kinase 1 (sFlt-1) and uterine artery Doppler for the detection of preeclampsia in women of advanced age at 16-18 weeks of gestation and to identify associations between other pregnancy complications and abnormalities of these combined tests. The maternal plasma sFlt-1 level was measured, and uterine artery Doppler was performed at 16-18 weeks of gestation in 314 cases of elderly gravida. The main outcome was preeclampsia. Fourteen women (4.46%) developed preeclampsia. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of uterine artery Doppler combined with plasma sFlt-1 for preeclampsia prediction were 28.6, 95.7, 23.5 and 96.6%, respectively. For the prediction of early-onset preeclampsia, the sensitivity, specificity, PPV and NPV were 80, 95.8, 23.5 and 99.7%, respectively. Patients with abnormal uterine artery Doppler findings and an abnormal plasma s Flt-1 level (greater than 1724.5 pg ml(-1)) had a higher risk of preterm delivery (relative risk (RR)=3.38, 95% confidence interval (CI) 1.47-7.59), neonatal respiratory distress syndrome (RR=52.06, 95% CI 5.71-474.45) and perinatal death (RR=17.35, 95% CI 1.13-265.64). Our findings indicate that the combination of uterine artery Doppler and sFlt-1 level at 16-18 weeks of gestation in cases of elderly gravida has a high predictive value for early-onset preeclampsia, but not for overall preeclampsia. This combination test may be a useful early second trimester screening test for the prediction of early-onset preeclampsia in cases of elderly gravida.

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“…The impaired placentation is one possible cause. 4 There are many studies that aim to evaluate risk factors of pre-eclampsia. Primigravida, previous pregnancy-induced hypertension, obesity, diabetes, hypertension and multiplicity are risk factors.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of early and late onset pre‐eclampsia

Aksornphusitaphong

Phupong

2012

J of Obstet and Gynaecol

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Aims: The aim of this study was to identify the differences in risk factors between early and late onset pre-eclampsia. Material and Methods: A case-control study was carried out involving pregnancies with pre-eclampsia (152 early onset and 297 late onset) and 449 controls at King Chulalongkorn Memorial Hospital, Bangkok, Thailand between 1 January 2005 and 31 December 2010. The data were reviewed from antenatal and delivery records. Results: Factors which were significantly associated with increased risk for both early and late onset preeclampsia were family history of diabetes mellitus, high pre-pregnancy body mass index Ն 25 kg/m 2 and weight gain Ն 0.5 kg per week. History of chronic hypertension (odds ratio 4.4; 95% confidence interval 2.1-9.3) was significantly associated with increased risk for only early onset pre-eclampsia, while family history of chronic hypertension (odds ratio 18; 95% confidence interval 6-54) was significantly associated with increased risk for only late onset pre-eclampsia. Conclusions:The risk factors that differ between early and late onset of pre-eclampsia were history of chronic hypertension and family history of chronic hypertension. Family history of diabetes mellitus, pre-pregnancy body mass index Ն 25 kg/m 2 and weight gain Ն 0.5 kg per week were risk factors of both early and late onset pre-eclampsia. These risk factors are of value to obstetricians in identifying patients at risk for pre-eclampsia and in implementing primary prevention.

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Predicting Risks of Preeclampsia and Small for Gestational Age Infant by Uterine Artery Doppler

Abstract: Women with an abnormal uterine artery Doppler great a considerably higher risk for developing preeclampsia and/or having an SGA infant.

Cited by 15 publications

References 26 publications

Colour Doppler in IUGR- Where are we and where do we go?

Colour Doppler in IUGR- Where are we and where do we go?

Combination of plasma-soluble fms-like tyrosine kinase 1 and uterine artery Doppler for the prediction of preeclampsia in cases of elderly gravida

Risk factors of early and late onset pre‐eclampsia

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