Uterine Artery Pulsatility Index Assessment at <11 Weeks' Gestation: A Prospective Study.

Autor:	Taylor TJ; South Coast Ultrasound for Women, Wollongong, New South Wales, Australia, traceyjtaylor15@gmail.com.; Discipline of Obstetrics, Gynaecology and Neonatology, Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia, traceyjtaylor15@gmail.com., Quinton AE; Discipline of Obstetrics, Gynaecology and Neonatology, Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.; School of Health, Medical and Applied Science, Central Queensland University, Sydney, New South Wales, Australia., de Vries BS; Discipline of Obstetrics, Gynaecology and Neonatology, Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.; RPA Women and Babies, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia., Hyett JA; Discipline of Obstetrics, Gynaecology and Neonatology, Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.; RPA Women and Babies, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	Fetal diagnosis and therapy [Fetal Diagn Ther] 2020; Vol. 47 (2), pp. 129-137. Date of Electronic Publication: 2019 Jul 05.
DOI:	10.1159/000500776
Abstrakt:	Objective: Mean uterine artery pulsatility index (meanUAPI) is commonly measured at 11-13+6 weeks to predict adverse pregnancy outcomes including hypertensive disorders and small-for-gestational age. The aims of this study were to establish a population-specific reference range for meanUAPI at <11 weeks, to determine if an abnormal meanUAPI at <11 weeks was associated with adverse pregnancy outcome, and to assess changes in meanUAPI between <11 weeks and 11-13+6 weeks. Methods: A prospective cohort was examined at <11 weeks and at 11-13+6 weeks to develop reference ranges for meanUAPI. Based on these regression models, meanUAPI Z-scores were compared between outcome groups using a two-sample t test. Longitudinal changes in the meanUAPI between <11 and 11-13+6 weeks were assessed by two-way mixed ANOVA. Results: Prior to 11 weeks, there was no significant difference in meanUAPI between normal (n = 622) and adverse (n = 80) outcomes (mean [95% CI]: 2.62 [2.57-2.67] and 2.67 [2.50-2.84], respectively; p = 0.807). At 11-13+6 weeks, meanUAPI was significantly higher in the adverse (n = 66) compared with the normal (n = 535) outcome group (mean [95% CI]: 1.87 [1.70-2.03] and 1.67 [1.63-1.72], respectively; p = 0.040). There was a statistically significant decrease (p < 0.0001) in meanUAPI between the two time points. Conclusion: MeanUAPI measured at <11 weeks' gestation does not appear to be a useful marker for the prediction of placental-related adverse pregnancy outcomes, supporting an argument for the prediction of risk at 11-13+6 weeks' gestation. (© 2019 S. Karger AG, Basel.)
Databáze:	MEDLINE
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