Role of uterine artery Doppler in interpreting low PAPP‐A values in first‐trimester screening for Down syndrome in pregnancies at high risk of impaired placentation

Abstract

Objectives Low maternal serum levels of pregnancyassociated plasma protein-A (PAPP-A) are associated with both increased risk of aneuploidies and impaired trophoblastic invasion, while high uterine artery (

Correlation between First-Trimester Maternal Serum Markers, Second-Trimester Uterine Artery Doppler Indices and Pregnancy Outcome

“…It seems that PAPPA levels at the first trimester have a better correlation with second-trimester UA Doppler findings. In two of the recent studies, the presence of significant association between PI of uterine artery and PAPPA in the first trimester has been reported [28,29] . But the detection rate of early screening for pre-eclampsia by maternal variables and Doppler was not improved by inclusion of PAPPA [29] .…”

Evaluation of 7 Serum Biomarkers and Uterine Artery Doppler Ultrasound for First-Trimester Prediction of Preeclampsia: A Systematic Review

“…4, 5). 14,36,37,[40][41][42][43][44][45][46][47][48][49]52 Median MoMs of Ut-A Doppler have been shown to be markedly higher in all variants of PE as compared with healthy pregnancies (Table 3). 14,23,[29][30][31]35,37,39,40,48,50,51 First-Trimester Prediction of Preeclampsia Y CME Review Article …”

“…3). 14,23,27,30,37,40,41,46,48,[50][51][52] For LO-PE and PE, reported DR have ranged between 5% and 62% (Figs. 4, 5).…”

“…However, several of the analyzed articles used one or more risk factors of maternal characteristics to improve first-trimester screening. 14,16,23,28,30,31,[36][37][38]40,[46][47][48]50,51 In this review, all maternal risk factors were analyzed together under the section called maternal characteristics. DR of maternal characteristics alone ranged from 23% to 56% in EO-PE, LO-PE, and PE (Figs.…”

“…27 Furthermore, combination of Ut-A Doppler with MC appears promising, ranging between 51% and 81%. 14,23,30,31,37,40,46,48,50,51 DR for the combination of more than 2 markers varied between 38% and 100% with the best results seen with the combination of 5 markers (Inhibin A, PlGF, PAPP-A, Ut-A Doppler, and MC). 14,15,23,30,31,37 …”