Volume 16, Issue 2 (2-2018)                   IJRM 2018, 16(2): 109-114 | Back to browse issues page

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Sharma N, Jayashree K, Nadhamuni K. Maternal history and uterine artery wave form in the prediction of early-onset and late-onset preeclampsia: A cohort study. IJRM. 2018; 16 (2) :109-114
URL: http://journals.ssu.ac.ir/ijrmnew/article-1-972-en.html
1- Department of Obstetrics and Gynaecology, Saveetha Medical College, Chennai, India , drbonuramkumar@yahoo.co.in
2- Department of Obstetrics and Gynaecology, Saveetha Medical College, Chennai, India.
3- Department of Radiology, Saveetha Medical College, Chennai, India
Abstract:   (206 Views)
Background: Pregnancy induced hypertension (PIH) is a significant cause of maternal morbidity and mortality. Pregnancy-induced-hypertension can be prevented by identification of prenatal and antenatal factors. The uterine artery Doppler waveform transforms into a high flow with low resistance at 22-24 wk. Objective: To study the maternal risk factors and uterine artery Doppler waveform in singleton mid-trimester pregnancy and predict the occurrence of pregnancy-induced hypertension. Materials and Methods: This is a cohort study comprising of Doppler ultrasound examination of the uterine arteries at 20-23 wk gestation in 697 women with singleton pregnancies attending a routine target scan. The pregnant women were followed up. PIH was recorded in 57 (8.18%) of all pregnancies. Results: Maternal age >34 yr, primiparity, the presence of chronic hypertension was also associated with increased risk of PIH. High pulsatility index (>95th percentile) as compared to low pulsatility index was a good tool for the detection of PIH (sensitivity 91.23% and specificity 99.06%, p<0.05). Presence of high pulsatility was a significant risk factor for early-onset PIH as compared to late-onset PIH. Conclusion: Uterine artery Doppler can be safely performed at the time of routine target anomaly scan in the second trimester. It is simple, economical, feasible and with good detection rates.
Full-Text [PDF 444 kb]   (83 Downloads) |   |   Full-Text (HTML)  (21 Views)  
Type of Study: Original Article |
Received: 2018/03/5 | Accepted: 2018/03/5 | Published: 2018/03/5

1. Muti M, Tshimanga M, Notion GT, Bangure D, Chonzi P. Prevalence of pregnancy-induced hypertension and pregnancy outcomes among women seeking maternity services in Harare, Zimbabwe. BMC Cardiovasc Disord 2015; 15: 111. [DOI:10.1186/s12872-015-0110-5]
2. Kurt Benirschke, Peter K aufman, Rebecca Baergen.Pathology of human placenta. 5th Ed. New York, Springer; 2006.
3. Burton GJ, Woods AW, Jauniaux E, Kingdom JC. Rheological and physiological consequences of conversion of the maternal spiral arteries for uteroplacental blood flow during human pregnancy. Placenta 2009; 30: 473-482. [DOI:10.1016/j.placenta.2009.02.009]
4. Pijenberg R, Bland JM, Robertson WB, Brosens I. Uteroplacental arterial cangesrelated to interstitial trophoblast migration in early human pregnancy. Placenta 1983; 4: 397-414. [DOI:10.1016/S0143-4004(83)80043-5]
5. Papageorghiou AT, Yu CK, Bindra R, Pandis G, Nicolaides KH, Fetal Medicine Foundation Second Trimester Screening Group. Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation. Ultrasound Obstet Gynecol 2001; 18: 441-449. [DOI:10.1046/j.0960-7692.2001.00572.x]
6. Cnossen JS, Morris RK, ter Riet G, Mol BW, van der Post JA, Coomarasamy A, et al. Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ 2008; 178: 701-711. [DOI:10.1503/cmaj.070430]
7. Konje JC, Kaufmann P, Bell SC, Taylor DJ. A longitudinal study of quantitative uterine uterine blood flow with the use of color Doppler angiography in appropriate for gestational age pregnancies. Am J Obstet Gynaecol 2001; 185: 608-613. [DOI:10.1067/mob.2001.117187]
8. Schaaps JP, Tsatsaris V. Uteroplacental vascularization. Gynecol Obstet Fertil 2001; 29: 509-511. [DOI:10.1016/S1297-9589(01)00182-5]
9. Schaaps JP, Tsatsaris V, Goffin F, Brichant JF, Delbecque K, Tebache M et al. Shunting the intervillous space: new concepts in human uteroplacental vascularization. Am J Obstet Gynecol 2005; 192: 323-332. [DOI:10.1016/j.ajog.2004.06.066]
10. Schiessl B, Innes BA, Bulmer JN, Otun HA, Chadwick TJ, Robson SC et al. Localization of angiogenic growth factors and their receptors in the human placental bed throughout normal human pregnancy. Placenta 2009; 30: 79-87. [DOI:10.1016/j.placenta.2008.10.004]
11. Kaufmann P, Black S, Huppertz B. Endovascular trophoblast invasion: implications for the pathogeneses of intrauterine growth retardation and preeclampsia. Biol Reprod 2003; 69:1-7. [DOI:10.1095/biolreprod.102.014977]
12. Hustin J, Schaaps JP. Echocardiographic and anatomic studies of the maternotrophoblastic border during the first trimester of pregnancy. Am J Obstet Gynaecol 1987; 157:162-168. [DOI:10.1016/S0002-9378(87)80371-X]
13. Rodesch F, Simon P, Donner C, Jauniaux E. Oxygen measurements in endometrial and trophoblastic tissues during early pregnancy. Obstet Gynecol 1992; 80:283-285.
14. Jauniaux E, Watson AL, Hempstock J, Bao YP, Skepper JN, Burton GJ. Onset of maternal arterial blood flow and placental oxidative stress. A possible factor in human early pregnancy failure. Am J Pathol 2000; 157:2111-2122. [DOI:10.1016/S0002-9440(10)64849-3]
15. García B, Llurba E, Valle L, Gómez-Roig MD, Juan M, Pérez-Matos C. Do knowledge of uterine artery resistance in the second trimester and targeted surveillance improve maternal and perinatal outcome? UTOPIA study: a randomized controlled trial. Ultrasound Obstet Gynecol 2016; 47: 680-689. [DOI:10.1002/uog.15873]
16. Llurba E, Carreras E, Gratacós E, Juan M, Astor J, Vives A, et al, Maternal history and uterine artery doppler in the assessment of risk for development of early-and late-onset preeclampsia and intrauterine growth restriction. Obstet Gynecol Int 2009; 2009: doi:10.1155/2009/275613. [DOI:10.1155/2009/275613]
17. Hunter S, Robson SC. Adaptation of maternal heart in pregnancy. Br Heart J 1992; 68: 540-543. [DOI:10.1136/hrt.68.12.540]
18. Lausman AY, Kingdom JC, Bradley TJ, Slorach C, Ray JC. Subclinical atherosclerosis in association with elevated placental vascular resistance in early pregnancy. Atherosclerosis 2009; 206: 33-35. [DOI:10.1016/j.atherosclerosis.2009.02.007]
19. Stergiotou I, Bijnens B, Cruz-Lemini M, Figueras F, Gratacos E, Crispi F. Maternal subclinical vascular changes in fetal growth restriction with and without pre-eclampsia. Ultrasound Obstet Gynecol 2015; 46: 706-712. [DOI:10.1002/uog.14815]
20. Spencer K, Cowans NJ, Chefetz I, Tal J, Meiri H. First trimester maternal serum PP-13, PAPP-A and second trimester uterine artery Doppler pulsatility index as markers of pre-eclampsia. Ultrasound Obstet Gynecol 2007; 29:128-134. [DOI:10.1002/uog.3876]
21. Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet 2005; 365: 785-799. [DOI:10.1016/S0140-6736(05)71003-5]
22. Murphy DJ, Stirrat GM. Mortality and morbidity associated with early-onset preeclampsia. Hypertens Pregnancy 2000; 19: 221-231. [DOI:10.1081/PRG-100100138]
23. Crispi F, Domínguez C, Llurba E, Martín-Gallán P, Cabero L, Gratacós E. Placental angiogenic growth factors and uterine artery Doppler findings for characterization of different subsets in pre-eclampsia and in isolated intrauterine growth restriction. Am J Obstet Gynecol 2006; 195: 201-207. [DOI:10.1016/j.ajog.2006.01.014]
24. Ness RB, Sibai BM. Shared and disparate components of the pathophysiologies of fetal growth restriction and preeclampsia. Am J Obstet Gynecol 2006; 195: 40-49. [DOI:10.1016/j.ajog.2005.07.049]
25. Sibai BM. Maternal and uteroplacental hemodynamics for the classification and prediction of preeclampsia. Hypertension 2008; 52: 805-806. [DOI:10.1161/HYPERTENSIONAHA.108.119115]

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