RESUMEN
OBJECTIVE: The aim of this study was to examine the diagnostic value of ophthalmic artery Doppler indices in predicting preeclampsia along with other markers in the third trimester of pregnancy. METHODS: Normotensive pregnancies were included during 28-32 weeks of gestation to undergo uterine and ophthalmic artery Doppler ultrasound. Maternal and fetal characteristics were documented at the visit between the 28 and 32 weeks of gestation, and pregnancy-associated plasma protein A (PAPP-A) values in the first trimester were collected to be integrated into a multiparametric prediction model. RESULTS: Of 795 included participants, 48 cases progressed to preeclampsia. All assessed ophthalmic Doppler parameters including first and second peak systolic velocities (PSVs), second to first peak ratio (PR), and pulsatility index (PI), were statistically different in patients who developed preeclampsia later on. The average PR (sensitivity: 100% [95% CI, 0.81-1.00]; specificity: 90% [95% CI, 0.86-0.93]) and PI between the eyes, PAPP-A multiple of median and uterine artery PI were determined to be the most important predictors of PE, which were subsequently integrated into a multiple regression model (sensitivity: 94% [95% CI, 0.70-1.00]; specificity: 93% [95% CI, 0.89-0.96]). CONCLUSION: This study provided a screening method for individuals at higher risk of progressing to preeclampsia in the third trimester of pregnancy.
Asunto(s)
Preeclampsia , Embarazo , Femenino , Humanos , Preeclampsia/diagnóstico por imagen , Proteína Plasmática A Asociada al Embarazo , Arteria Oftálmica/diagnóstico por imagen , Arteria Oftálmica/metabolismo , Ultrasonografía Prenatal/métodos , Arteria Uterina/diagnóstico por imagen , Primer Trimestre del Embarazo , Ultrasonografía Doppler/métodos , Biomarcadores , Flujo PulsátilAsunto(s)
Diabetes Gestacional , Síndrome del Ovario Poliquístico , Complicaciones del Embarazo , Embarazo , Femenino , Humanos , Resultado del Embarazo , Síndrome del Ovario Poliquístico/complicaciones , Diabetes Gestacional/etiología , Complicaciones del Embarazo/prevención & control , Complicaciones del Embarazo/etiologíaRESUMEN
BACKGROUND: This study aims to assess the association between first-trimester biomarkers in foetuses with a non-chromosomal congenital heart defect (CHD) and compares it to the matched healthy foetuses. METHOD: Nuchal Translucency (NT), Pregnancy-Associated Plasma Protein-A (PAPP-A) and free beta-human Chorionic Gonadotropin (ß-hCG) were evaluated in 56 isolated foetal heart defects and 224 controls. The CHDs were further divided into Critical CHD (C-CHD) and Non-critical CHD (N-CHD) groups. RESULTS: The multiple of the median (MoM) values for PAPP-A were significantly lower (0.87 MoM vs. 0.92 MoM; p = 0.008) in the total CHD group than in controls. The median of foetal NT values was significantly higher in the total CHDs than in controls (1.16 MoM vs. 1.03 MoM; p < 0.001), especially for C-CHDs (1.28 MoM; P < 0.001). There were no significant differences in terms of PAPP-A (p = 0.779) and foetal NT values (p = 0.760) between the N-CHDs and control groups. There were no significant differences within the groups based on free ß-hCG, except for a lower ß-hCG in C-CHD group than in the control group (0.95 MoM vs. 1.11 MoM; p = 0.022). CONCLUSION: Lower PAPP-A levels and increased NT thickness were associated with an increased risk of CHDs, especially the critical type of CHDs.Clinical significanceMaternal serum PAPP-A, measured in the first trimester, is significantly lower in CHD.Foetal NT is significantly thicker in foetuses with CHD, especially those with critical CHD.Maternal serum ß-hCG was only decreased among critical CHD group.