RESUMO
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.
Assuntos
Síndrome Antifosfolipídica , Lúpus Eritematoso Sistêmico , Morte Perinatal , Pré-Eclâmpsia , Feminino , Recém-Nascido , Humanos , Gravidez , Artéria Uterina/diagnóstico por imagem , Segundo Trimestre da Gravidez , Síndrome Antifosfolipídica/complicações , Placenta , Retardo do Crescimento Fetal , Pré-Eclâmpsia/diagnóstico , Lúpus Eritematoso Sistêmico/complicações , Ultrassonografia Pré-Natal , Fluxo PulsátilRESUMO
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 (Assuntos
Sofrimento Fetal
, Mecônio
, Artéria Cerebral Média
, Gravidez Prolongada
, Fluxo Pulsátil
, Ultrassonografia Doppler/métodos
, Adulto
, Feminino
, Sofrimento Fetal/diagnóstico
, Sofrimento Fetal/etiologia
, Humanos
, Recém-Nascido
, Artéria Cerebral Média/diagnóstico por imagem
, Artéria Cerebral Média/fisiopatologia
, Valor Preditivo dos Testes
, Gravidez
, Resultado da Gravidez/epidemiologia
, Gravidez Prolongada/epidemiologia
, Gravidez Prolongada/fisiopatologia
, Espanha/epidemiologia