First-trimester umbilical vein blood flow in pregnancies with low serum pregnancy-associated plasma protein-A levels: an early predictor of fetal growth restriction

Autor: Domenico Arduini, Antonio Capece, Maria Elena Pietrolucci, Giuseppe Rizzo, Alessandra Capponi
Rok vydání: 2010
Předmět:
Zdroj: Ultrasound in Obstetrics and Gynecology. 36:433-438
ISSN: 0960-7692
Popis: Objective To investigate umbilical vein blood flow (UVBF) during the first trimester in pregnancies with low serum pregnancy-associated plasma protein-A (PAPP-A) levels and to relate umbilical vein (UV) diameter, time-averaged maximum velocity (TAMXV) and UVBF values to the subsequent development of fetal intrauterine growth restriction (IUGR). Methods UVBF assessment was performed at 11 + 0 to 13 + 6 weeks' gestation in 102 singleton pregnancies with PAPP-A concentrations of < 0.3 multiples of the median. UV diameter, UV-TAMXV and UVBF were calculated and analyzed in relation to pregnancy outcome. Results Pregnancy outcomes were: 51 pregnancies with birth weight ≥ 10th centile (Group A), 30 pregnancies with birth weight < 10th centile with normal Doppler in the umbilical artery throughout gestation (Group B) and 21 pregnancies with birth weight < 10th centile and abnormal umbilical artery Doppler later in gestation (Group C). No differences were found in PAPP-A levels between groups. Group C fetuses exhibited significantly lower values of UV-TAMXV (z-score − 1.99 SDs, t = 8.527, P ≤ 0.0001) and UVBF (z-score − 0.97 SDs, t = 7.420, P ≤ 0.0001) in comparison with normal reference ranges, while no differences were found in Groups A or B. Conclusions Decreased UV-TAMXV and UVBF at 11 + 0 to 13 + 6 weeks' gestation identify fetuses at risk of developing IUGR among pregnancies with low levels of PAPP-A. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Databáze: OpenAIRE