ABSTRACT
OBJECTIVE: To assess the value of the second trimester mean pulsatility index of the uterine arteries (MPI-UtA) to predict adverse perinatal outcome (APO) in women with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). METHODS: Pregnancies with either an SLE diagnosis or with primary APS controlled at our Hospital during a 10 years period were included. MPI-UtA was performed between 19-23 weeks' gestation. The MPI-UtA was defined as abnormal when it was >95th centile. APO was defined as the presence of: preeclampsia (PE), small for gestational age (SGA) newborn, preterm delivery, placental abruption and fetal or neonatal death. RESULTS: There were 39 ongoing pregnancies, 16 of them with SLE and 23 with primary APS. Nine patients had no previous pregnancy (23%). Globally, 35 live births were recorded, being the mean gestational age at delivery 38.1 ± 2.1 weeks and the mean birth weight 2835 ± 492 g. Abnormal MPI-UtA was found in 6 (15%) pregnancies, all of them (100%) had an APO: there were 4 fetal deaths and 2 further severe PE with live newborn. Normal MPI-UtA was shown in the remaining 33 (84.6%); of them, 6 (18%) had an APO: one late PE with a premature newborn, another one severe preterm baby and 4 SGA term newborns. No cases of perinatal death occurred in this group. Therefore, accuracy of MPI-UtA evaluation for APO was: sensitivity 50%, specificity 100%, PPV 100% and NPV 82%, respectively (p < .001). CONCLUSION: Abnormal second-trimester uterine artery Doppler evaluation is highly predictive for adverse perinatal outcome in pregnancies affected by SLE or APS.
Subject(s)
Antiphospholipid Syndrome , Lupus Erythematosus, Systemic , Perinatal Death , Pre-Eclampsia , Female , Infant, Newborn , Humans , Pregnancy , Uterine Artery/diagnostic imaging , Pregnancy Trimester, Second , Antiphospholipid Syndrome/complications , Placenta , Fetal Growth Retardation , Pre-Eclampsia/diagnosis , Lupus Erythematosus, Systemic/complications , Ultrasonography, Prenatal , Pulsatile FlowABSTRACT
OBJECTIVES: The aim of this study was to asses the correlation of middle cerebral artery pulsatility index (MCA-PI) and perinatal outcomes in prolonged pregnancies. STUDY DESIGN: This was a prospective study of all consecutive pregnant women beyond 41 weeks' gestation attending for obstetric surveillance during a two years period. We evaluated the predictive value of MCA-PI lower than the 5th percentile (Subject(s)
Fetal Distress
, Meconium
, Middle Cerebral Artery
, Pregnancy, Prolonged
, Pulsatile Flow
, Ultrasonography, Doppler/methods
, Adult
, Female
, Fetal Distress/diagnosis
, Fetal Distress/etiology
, Humans
, Infant, Newborn
, Middle Cerebral Artery/diagnostic imaging
, Middle Cerebral Artery/physiopathology
, Predictive Value of Tests
, Pregnancy
, Pregnancy Outcome/epidemiology
, Pregnancy, Prolonged/epidemiology
, Pregnancy, Prolonged/physiopathology
, Spain/epidemiology