Prognostic role of uterine artery Doppler in early- and late-onset preeclampsia with severe features

Chilumula, Keerthi; Saha, Pradip Kumar; Muthyala, Tanuja; Saha, Subhas Chandra; Sundaram, Venkataseshan; Suri, Vanita

doi:10.1007/s40477-020-00524-0

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…Both left uterine artery notching and mean uterine PI > 95th centile were significantly correlated with babies being small for their gestational age (RR 1.76 and 1.83, respectively), pre-eclampsia (RR 2.53, 1.98, respectively), and early-onset pre-eclampsia (RR 2.88, RR 3.13). Chilumula [ 67 ] studied the correlation between uterine artery Doppler findings and adverse pregnancy outcomes in a population of women diagnosed with early- or late-onset severe preeclampsia. Early uterine diastolic notch was twice as likely to occur in the early-onset form than in late-onset preeclampsia(80% vs. 40%, p = 0.003).…”

Section: Relevant Data From the Recent Literature Regarding The Value...mentioning

confidence: 99%

The Current Role of the sFlt-1/PlGF Ratio and the Uterine–Umbilical–Cerebral Doppler Ultrasound in Predicting and Monitoring Hypertensive Disorders of Pregnancy: An Update with a Review of the Literature

Chirilă,

Mărginean,

Chirilă

et al. 2023

Children

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Regarding the hypertensive disorders of pregnancy, pre-eclampsia (PE) remains one of the leading causes of severe and life-threatening maternal and fetal complications. Screening of early-onset PE (<34 weeks of pregnancy), as well as late-onset PE (≥34 weeks), shows poor performance if based solely on clinical features. In recent years, biochemical markers from maternal blood—the pro-angiogenic protein placental growth factor (PlGF) and the antiangiogenic protein soluble FMS-like tyrosine kinase 1 (sFlt-1)—and Doppler velocimetry indices—primarily the mean uterine pulsatility index (PI), but also the uterine resistivity index (RI), the uterine systolic/diastolic ratio (S/D), uterine and umbilical peak systolic velocity (PSV), end-diastolic velocity (EDV), and uterine notching—have all shown improved screening performance. In this review, we summarize the current status of knowledge regarding the role of biochemical markers and Doppler velocimetry indices in early prediction of the onset and severity of PE and other placenta-related disorders, as well as their role in monitoring established PE and facilitating improved obstetrical surveillance of patients categorized as high-risk in order to prevent adverse outcomes. A sFlt-1/PlGF ratio ≤ 33 ruled out early-onset PE with 95% sensitivity and 94% specificity, whereas a sFlt-1/PlGF ≥88 predicted early-onset PE with 88.0% sensitivity and 99.5% specificity. Concerning the condition’s late-onset form, sFlt-1/PlGF ≤ 33 displayed 89.6% sensitivity and 73.1% specificity in ruling out the condition, whereas sFlt-1/PlGF ≥ 110 predicted the condition with 58.2% sensitivity and 95.5% specificity. The cut-off values of the sFlt-1/PlGF ratio for the screening of PE were established in the PROGNOSIS study: a sFlt-1/PlGF ratio equal to or lower than 38 ruled out the onset of PE within one week, regardless of the pregnancy’s gestational age. The negative predictive value in this study was 99.3%. In addition, sFlt-1/PlGF > 38 showed 66.2% sensitivity and 83.1% specificity in predicting the occurrence of PE within 4 weeks. Furthermore, 2018 ISUOG Practice Guidelines stated that a second-trimester mean uterine artery PI ≥ 1.44 increases the risk of later PE development. The implementation of a standard screening procedure based on the sFlt-1/PlGF ratio and uterine Doppler velocimetry may improve early detection of pre-eclampsia and other placenta-related disorders.

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Section: Relevant Data From the Recent Literature Regarding The Value...mentioning

confidence: 99%

The Current Role of the sFlt-1/PlGF Ratio and the Uterine–Umbilical–Cerebral Doppler Ultrasound in Predicting and Monitoring Hypertensive Disorders of Pregnancy: An Update with a Review of the Literature

Chirilă,

Mărginean,

Chirilă

et al. 2023

Children

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“…Biometrical and blood flow assessments are currently the best tools for examining in utero development, cardiovascular health, and the diagnosis and management of several high-risk pregnancy conditions, such as preeclampsia, congenital diseases, and placental insufficiency [ 1 , 2 , 3 ]. In terms of blood flow measurements, the most explored vascular beds are the uterine (UtA), umbilical (UA), and middle cerebral artery (MCA).…”

Section: Introductionmentioning

confidence: 99%

Developmental Ultrasound Characteristics in Guinea Pigs: Similarities with Human Pregnancy

Candia

Jiménez

Navarrete

et al. 2023

Veterinary Sciences

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Background: Biometrical and blood flow examinations are fundamental for assessing fetoplacental development during pregnancy. Guinea pigs have been proposed as a good model to study fetal development and related gestational complications; however, longitudinal growth and blood flow changes in utero have not been properly described. This study aimed to describe fetal and placental growth and blood flow of the main intrauterine vascular beds across normal guinea pig pregnancy and to discuss the relevance of this data for human pregnancy. Methods: Pregnant guinea pigs were studied from day 25 of pregnancy until term (day ~70) by ultrasound and Doppler assessment. The results were compared to human data from the literature. Results: Measurements of biparietal diameter (BPD), cranial circumference (CC), abdominal circumference, and placental biometry, as well as pulsatility index determination of umbilical artery, middle cerebral artery (MCA), and cerebroplacental ratio (CPR), were feasible to determine across pregnancy, and they could be adjusted to linear or nonlinear functions. In addition, several of these parameters showed a high correlation coefficient and could be used to assess gestational age in guinea pigs. We further compared these data to ultrasound variables from human pregnancy with high similarities. Conclusions: BPD and CC are the most reliable measurements to assess fetal growth in guinea pigs. Furthermore, this is the first report in which the MCA pulsatility index and CPR are described across guinea pig gestation. The guinea pig is a valuable model to assess fetal growth and blood flow distribution, variables that are comparable with human pregnancy.

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“…Preeclampsia's pathogenesis is not entirely understood, although the placenta has always played a significant role in its etiology because it must be removed for symptoms to improve [6] .…”

Section: Introductionmentioning

confidence: 99%

Measurement of Third-Trimester Uterine Artery Doppler for Evaluation of Maternal Postpartum Outcome among Patients with Severe Pre-Eclampsia

El Nagar,

El Sheikha,

Sedek

2023

International Journal of Medical Arts

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Article informationBackground: Preeclampsia is a frequent pregnancy disease that accounts for a significant portion of maternal and foetal morbidity and mortality. Eclampsia, pulmonary edema, HELLP syndrome, cerebral hemorrhage, severe renal failure, placental abruption, and disseminated intravascular coagulation are among the maternal consequences of pre-eclampsia [DIC]. Aim of the work:To analyze the relationship between maternal problems and uterine artery Doppler measures in women with severe pre-eclampsia.Patients and Methods: 200 pregnant patients from Sayed Galal and Shebin El-Kom teaching hospitals participated in a case-control study. Two groups of pregnant women were used in this study.Group I [Case group] consisted of 100 pregnant women with viable singleton pregnancies and no other obstetric complications or morbidities aside from preeclampsia. There were 100 expectant women in Group II [the Control group] who did not have pre-eclampsia. At admission, uterine artery Doppler was performed, and the postpartum result was assessed.Results: Uterine artery When compared to the control group, the case group's Doppler had a much higher resistance, which was linked to an increase in eclampsia, oliguria, renal failure, HELLP, and blood transfusions. Conclusion:Third trimester High-resistance uterine artery Doppler can be used to predict adverse postpartum outcome.

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Prognostic role of uterine artery Doppler in early- and late-onset preeclampsia with severe features

Cited by 6 publications

References 23 publications

The Current Role of the sFlt-1/PlGF Ratio and the Uterine–Umbilical–Cerebral Doppler Ultrasound in Predicting and Monitoring Hypertensive Disorders of Pregnancy: An Update with a Review of the Literature

The Current Role of the sFlt-1/PlGF Ratio and the Uterine–Umbilical–Cerebral Doppler Ultrasound in Predicting and Monitoring Hypertensive Disorders of Pregnancy: An Update with a Review of the Literature

Developmental Ultrasound Characteristics in Guinea Pigs: Similarities with Human Pregnancy

Measurement of Third-Trimester Uterine Artery Doppler for Evaluation of Maternal Postpartum Outcome among Patients with Severe Pre-Eclampsia

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