Serdar Balcı1. 1. Department of Gynecology and Obstetrics, Başkent University School of Medicine, Ankara, Turkey.
Abstract
OBJECTIVE: To determine predictive values of maternal serum PAPP-A (msPAPP-A) levels, uterine artery Doppler velocimetry, and fetal biometric measurements (FBMs) for poor pregnancy and poor neonatal outcomes. MATERIAL AND METHODS: This prospective cohort study was conducted on singleton pregnancies followed until delivery. Pregnancy and neonatal outcomes were evaluated with respect to the msPAPP-A level at the 11(th)-14(th) weeks, uterine artery Doppler velocimetry at the 15(th)-18(th) weeks, and FBMs at the 20(th)-24(th) and 28(th)-32(nd) weeks of pregnancy. RESULTS: One hundred fifty-eight women constituted the study group; 17 (10.75%) of them had at least one poor pregnancy outcome. The cut-off point of 0.72 multiple of the median (MoM) for the PAPP-A level achieved a sensitivity of 82.4% and a specificity of 29.8% for poor pregnancy outcomes. The mean birth weight was significantly lower in the subgroup with a higher mean pulsatility index of uterine arteries (UAPImean≥1.19) (p=0.025) as well as in the subgroup with a higher mean resistance index of uterine arteries (UARImean≥0.62) (p=0.013). When the subgroup of pregnant women under the risk of early-onset IUGR according to FBMs was compared to the low-risk group, statistically significant differences were seen in terms of pregnancy outcomes (p=0.045) and birth weight (p=0.011). CONCLUSION: Maternal serum PAPP-A level and FBMs could be used for predicting pregnancy outcomes, while uterine artery Doppler velocimetry and FBMs could be used for predicting neonatal outcomes, specifically the birth weight.
OBJECTIVE: To determine predictive values of maternal serum PAPP-A (msPAPP-A) levels, uterine artery Doppler velocimetry, and fetal biometric measurements (FBMs) for poor pregnancy and poor neonatal outcomes. MATERIAL AND METHODS: This prospective cohort study was conducted on singleton pregnancies followed until delivery. Pregnancy and neonatal outcomes were evaluated with respect to the msPAPP-A level at the 11(th)-14(th) weeks, uterine artery Doppler velocimetry at the 15(th)-18(th) weeks, and FBMs at the 20(th)-24(th) and 28(th)-32(nd) weeks of pregnancy. RESULTS: One hundred fifty-eight women constituted the study group; 17 (10.75%) of them had at least one poor pregnancy outcome. The cut-off point of 0.72 multiple of the median (MoM) for the PAPP-A level achieved a sensitivity of 82.4% and a specificity of 29.8% for poor pregnancy outcomes. The mean birth weight was significantly lower in the subgroup with a higher mean pulsatility index of uterine arteries (UAPImean≥1.19) (p=0.025) as well as in the subgroup with a higher mean resistance index of uterine arteries (UARImean≥0.62) (p=0.013). When the subgroup of pregnant women under the risk of early-onset IUGR according to FBMs was compared to the low-risk group, statistically significant differences were seen in terms of pregnancy outcomes (p=0.045) and birth weight (p=0.011). CONCLUSION: Maternal serum PAPP-A level and FBMs could be used for predicting pregnancy outcomes, while uterine artery Doppler velocimetry and FBMs could be used for predicting neonatal outcomes, specifically the birth weight.
Authors: Lorraine Dugoff; Anne M Lynch; Darleen Cioffi-Ragan; John C Hobbins; Lisa K Schultz; Fergal D Malone; Mary E D'Alton Journal: Am J Obstet Gynecol Date: 2005-09 Impact factor: 8.661
Authors: Rachel K Morris; Jeltsje S Cnossen; Marloes Langejans; Stephen C Robson; Jos Kleijnen; Gerben Ter Riet; Ben W Mol; Joris A M van der Post; Khalid S Khan Journal: BMC Pregnancy Childbirth Date: 2008-08-04 Impact factor: 3.007
Authors: Stephanie Cooper; Jo-Ann M Johnson; Amy Metcalfe; Jeffery Pollard; Rebecca Simrose; Gregory Connors; Donna Jones; Anne Roggensack; Richard Krause; Ian Lange Journal: Prenat Diagn Date: 2009-03 Impact factor: 3.050