Value of shear-wave elastography and cerebral–placental–uterine ratio in women diagnosed with preeclampsia and fetal growth restriction in prediction of adverse perinatal outcomes

Anuk, Ali Taner; Erol, Seyit Ahmet; Alkan, Mihriban; Altınboğa, Orhan; Karaçor, Talip; Keskin, Hüseyin Levent; Uygur, Dilek

doi:10.1080/14767058.2022.2081804

Cited by 8 publications

(10 citation statements)

References 30 publications

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“…Although PE is a severe complication of pregnancy, its exact mechanism is not yet fully understood. 9 Some studies [10][11][12] Prior studies [22][23][24] have also shown that calculating modulus values, VI, FI, VFI indices, and perfusion scores may not be fully objective. When placental tissue is heterogeneous or non-directional, measurement errors can occur.…”

Section: Discussionmentioning

confidence: 99%

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The clinical value of combining shear wave elastography, VOCAL technique, and T2* MRI of early gestation placenta to predict pre‐eclampsia

Xie,

Man,

Wan

et al. 2023

J of Clinical Ultrasound

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ObjectiveTo investigate the clinical value of combining shear wave elastography (SWE) with the Volumetric Organ Computer‐Aided AnaLysis (VOCAL) technique and T2* magnetic resonance imaging (MRI) to predict pre‐eclampsia (PE).MethodsFrom December 2022 to March 2023, we recruited 31 pregnant women diagnosed with PE at our hospital as the observation group and 85 normal pregnant women as the control group. Differences in placental elasticity, vascularization index (VI), flow index (FI), vascularization flow index (VFI), and T2* MRI perfusion fraction (f) were compared between the two groups. Received operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of placental elasticity, VI, FI, VFI, f, and their combination for predicting PE.ResultsPlacental elasticity was higher in the observation group than in the control group, while VI, FI, VFI, and f were lower in the observation group (all p < 0.05). The area under the curve (AUC) for placental elasticity, VI, FI, VFI, f, and their combination for predicting PE were 0.85, 0.77, 0.78, 0.84, 0.65, and 0.94, respectively. The sensitivity was 71%, 55%, 94%, 65%, 55%, and 81%. The specificity was 92%, 91%, 60%, 92%, 79%, and 98%. The combined prediction model had a higher AUC than the individual predictors (p < 0.05).ConclusionSWE combined with VOCAL technique and T2* MRI has high value for predicting PE and can provide reference information for clinical diagnosis.

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Section: Discussionmentioning

confidence: 99%

“…Prior studies 22–24 have also shown that calculating modulus values, VI, FI, VFI indices, and perfusion scores may not be fully objective. When placental tissue is heterogeneous or non‐directional, measurement errors can occur.…”

Section: Discussionmentioning

confidence: 99%

The clinical value of combining shear wave elastography, VOCAL technique, and T2* MRI of early gestation placenta to predict pre‐eclampsia

Xie,

Man,

Wan

et al. 2023

J of Clinical Ultrasound

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“…Preeclampsia is characterized by abnormal placentation, and stiffness of the placenta is significantly increased in preeclamptic patients compared to controls [162]. Studies have shown that Adm- and Clr -deficient embryos have defects in trophoblast cell invasion [163], indicating that ADE101 may improve feto–placental development in RUPP rats by reinforcing CLR/RAMP-mediated angiogenesis, increasing vascular barrier integrity, and improving placentation [162]. RUPP also leads to dysregulated immune responses [164].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, studies on the delayed pharmacological effect of ADE101 in different organs and its efficacy after the RUPP phenotype has become evident could be essential in evaluating its efficacy/risk profile because it may have a long residence time in vivo and affect various vascular beds. Preeclampsia is characterized by abnormal placentation, and stiffness of the placenta is significantly increased in preeclamptic patients compared to controls [162]. Studies have shown that Admand Clr-deficient embryos have defects in trophoblast cell invasion [163], indicating that ADE101 may improve feto-placental development in RUPP rats by reinforcing CLR/RAMP-mediated angiogenesis, increasing vascular barrier integrity, and improving placentation [162].…”

Section: Discussionmentioning

confidence: 99%

Stable adrenomedullin analog mitigates placental ischemia-induced hypertension and fetal growth restriction in rats

Chang

Cai²,

Hsu³

2023

Journal of Hypertension

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Objective(s):Preeclampsia is a heterogeneous hypertensive disorder of pregnancy. It affects multiorgans and may lead to fetal growth restriction, organ failure, seizure, and maternal death. Unfortunately, current treatments are ineffective at delaying the progression of preeclampsia even for a few days. Clinicians are often forced to deliver preterm fetus if severe preeclampsia occurred early during pregnancy, leading to premature birth-associated complications. Preeclampsia has been associated with defects at the maternal–fetal interface and maternal vascular dysfunction. Of interest, the adrenomedullin peptide and its cognate receptors, calcitonin receptor-like receptor (CLR)/ receptor activity-modifying protein (RAMP) receptor complexes, have been shown to be important regulators of cardiovascular adaptation and feto-placental development during pregnancy. Although the exact role of adrenomedullin-CLR/RAMP signaling in different feto-maternal compartments during pregnancy and how adrenomedullin expression affects preeclampsia development remains to be clarified, we hypothesized that the sustained activation of CLR/RAMP receptors could be a promising strategy to mitigate placental ischemia-associated vascular dysfunction and fetal growth restriction under preeclampsia-like conditionsMethods:To explore this possibility, we have developed a stable adrenomedullin analog, ADE101, and investigated its effects on human lymphatic microvascular endothelial (HLME) cell proliferation, hemodynamics, and pregnancy outcomes in pregnant rats with reduced uteroplacental perfusion pressure (RUPP) induced by clipping of uterine arteries on gestation day 14Results:The ADE101 analog has a potent effect on CLR/RAMP2 receptor activation, and an enhanced stimulatory effect on HLME cell proliferation compared to wild-type peptides. ADE101 also exhibits a lasting effect on hemodynamics in normal and hypertensive rats. In addition, studies using the RUPP model showed that ADE101 significantly reduces placental ischemia-induced hypertension and fetal growth restriction in a dose-dependent manner. Infusion of ADE101 increased the weight of fetuses and placentas in RUPP animals to 252% and 202% of that of RUPP controls, respectively.Conclusions:These data suggested that long-acting adrenomedullin analog could be useful for quenching hypertension as well as the vascular ischemia-associated organ damages in preeclamptic patients.

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“…Нарушение плацентации («дефективная плацентация») с ранней раскупоркой, вместе с ограниченной инвазией спиральных артерий вневорсинчастым трофобластом, приводит к нарушению ремоделирования и может повлечь за собой раннее развитие преэклампсии, которая часто сочетается с ЗРП или ЗРП без преэклампсии [4,7].…”

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Современные Взгляды На Проблему Задержки Роста Плода Как Осложнения Постковидного Эндотелиита

Жабченко¹,

Лищенко²

2022

РепроМед

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Актуальность: Чаще всего отставание роста ребенка на внутриутробном этапе возникает на фоне недостаточного поступления или усвоения питательных веществ и кислорода. Основными причинами таких нарушений являются патологические изменения в фетоплацентарной системе, организмах матери и плода, плодных оболочках. Задержка роста плода (ЗРП) может возникать под влиянием разных факторов. Риск ЗРП повышается под влиянием острых инфекций, гинекологических патологий, эндокринных заболеваний и недостаточного питания женщин. Частота ЗРП в популяции очень вариабельна: от 3-5% у практически здоровых беременных до 10-25% при отягощенном акушерско-гинекологическом диагнозе.Морфофункциональные нарушения в хорионе/плаценте у беременных на фоне постковидного эндотелиита являются основным патогенетическим фактором развития преэклампсии, ЗРП, антенатальной гибели плода и нарушенного состояния плода и новорожденных. Цель исследования – повысить клиническую информированность врачебного сообщества о проблеме задержки роста плода на фоне коронавирусной болезни во время беременности. Методы: Был проведен анализ специальной литературы по патогенезу, диагностике, влиянию на жизнь и здоровье новорожденного, имеющего ЗРП, у женщин после перенесенного COVID-19, а также возможностям медикаментозной коррекции плацентарной дисфункции во время беременности. Результаты: В статье приведены современные литературные данные о влиянии COVID-19 (SARS-CoV-2) на течение беременности и перинатальные последствия, в частности влияние на эндотелий сосудов и развитие плацентарной дисфункции и ЗРП. Отражены современные взгляды на потенциальные пути медикаментозной профилактики сосудистых и метаболических нарушений у беременных на фоне перенесенной коронавирусной болезни. Обоснована целесообразность использования с этой целью препарата на основе L-аргинина в комбинации с улучшением микроциркуляции с помощью гиперосмолярного кристаллоидного раствора на основе сорбитола. Заключение: Формирование плацентарной дисфункции и ЗРП после перенесенной во время беременности коронавирусной инфекции часто угрожают дальнейшему развитию ребенка. Достаточное насыщение организма беременной донатором оксида азота L-аргинином наряду с улучшением микроциркуляции и коррекцией гиповолемических нарушений в фетоплацентарном кровотоке можно считать одним из реальных путей профилактики ЗРП у женщин в постковидном периоде.

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Value of shear-wave elastography and cerebral–placental–uterine ratio in women diagnosed with preeclampsia and fetal growth restriction in prediction of adverse perinatal outcomes

Cited by 8 publications

References 30 publications

The clinical value of combining shear wave elastography, VOCAL technique, and T2* MRI of early gestation placenta to predict pre‐eclampsia

The clinical value of combining shear wave elastography, VOCAL technique, and T2* MRI of early gestation placenta to predict pre‐eclampsia

Stable adrenomedullin analog mitigates placental ischemia-induced hypertension and fetal growth restriction in rats

Современные Взгляды На Проблему Задержки Роста Плода Как Осложнения Постковидного Эндотелиита

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