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Vincze M, Sikovanyecz J, Földesi I, Surányi A, Várbíró S, Németh G, Sikovanyecz J, Kozinszky Z. Galectin-13 and Laeverin Levels Interfere with Human Fetoplacental Growth. Int J Mol Sci 2024; 25:6347. [PMID: 38928055 PMCID: PMC11203466 DOI: 10.3390/ijms25126347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
Galectin-13 (Gal-13) is predominantly produced by the syncytiotrophoblast, while laeverin is expressed on the outgrowing extravillous trophoblast, and both are thought to be biomarkers of preeclampsia. The aim of this study was to assess the correlation between concentrations of Gal-13 and laeverin measured in maternal serum and amniotic fluid at 16-22 weeks of gestation and the sonographic assessment of the fetoplacental measurements. Fetal biometric data and placental volume and perfusion indices were measured in 62 singleton pregnancies. Serum and amniotic levels of Gal-13 and laeverin levels were measured using a sandwich ELISA. Both amniotic fluid and serum Gal-13 levels expressed a negative correlation to the plasma laeverin level in mid-pregnancy. Serum laeverin level correlated positively with the gestational length at delivery (β = 0.39, p < 0.05), while the amniotic laeverin level correlated well with the abdominal circumference of the fetus (β = 0.44, p < 0.05). Furthermore, laeverin level in the amnion correlated positively with the estimated fetal weight (β = 0.48, p < 0.05) and with the placental volume (β = 0.32, p < 0.05). Logistic regression analyses revealed that a higher circulating Gal-13 level represents a slightly significant risk factor (OR: 1.01) for hypertension-related diseases during pregnancy. It is a novelty that laeverin can be detected in the amniotic fluid, and amnion laeverin concentration represents a potential biomarker of fetoplacental growth.
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Affiliation(s)
- Márió Vincze
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Imre Földesi
- Department of Laboratory Medicine, University of Szeged, H-6720 Szeged, Hungary;
| | - Andrea Surányi
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Gábor Németh
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Zoltan Kozinszky
- Capio Specialized Center for Gynecology, Solna, 182 88 Stockholm, Sweden
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Vincze M, Sikovanyecz J, Földesi I, Surányi A, Várbíró S, Németh G, Kozinszky Z, Sikovanyecz J. How the Soluble Human Leukocyte Antigen-G levels in Amniotic Fluid and Maternal Serum Correlate with the Feto-Placental Growth in Uncomplicated Pregnancies. Bioengineering (Basel) 2024; 11:509. [PMID: 38790375 PMCID: PMC11117885 DOI: 10.3390/bioengineering11050509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/18/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Introduction: Trophoblast-derived angiogenic factors are considered to play an important role in the pathophysiology of various complications of pregnancy. Human Leukocyte Antigen-G (HLA-G) belongs to the non-classical human major histocompatibility complex (MHC-I) molecule and has membrane-bound and soluble forms. HLA-G is primarily expressed by extravillous cytotrophoblasts located in the placenta between the maternal and fetal compartments and plays a pivotal role in providing immune tolerance. The aim of this study was to establish a relationship between concentrations of soluble HLA-G (sHLA-G) in maternal serum and amniotic fluid at 16-22 weeks of gestation and the sonographic measurements of fetal and placental growth. Materials and methods: sHLA-G in serum and amniotic fluid, as well as fetal biometric data and placental volume and perfusion indices, were determined in 41 singleton pregnancies with no complications. The level of sHLA-G (U/mL) was tested with a sandwich enzyme-linked immunosorbent assay (ELISA) kit. Results: The sHLA-G levels were unchanged both in amniotic fluid and serum during mid-pregnancy. The sHLA-G level in serum correlated positively with amniotic sHLA-G level (β = 0.63, p < 0.01). Serum sHLA-G level was significantly correlated with abdominal measurements (β = 0.41, p < 0.05) and estimated fetal weight (β = 0.41, p < 0.05). Conversely, amniotic sHLA-G level and placental perfusion (VI: β = -0.34, p < 0.01 and VFI: β = -0.44, p < 0.01, respectively) were negatively correlated. A low amniotic sHLA-G level was significantly associated with nuchal translucency (r = -0.102, p < 0.05). Conclusions: sHLA-G assayed in amniotic fluid might be a potential indicator of placental function, whereas the sHLA-G level in serum can be a prognostic factor for feto-placental insufficiency.
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Affiliation(s)
- Márió Vincze
- Department of Obstetrics and Gynecology, Albert Szent-Gyorgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, Albert Szent-Gyorgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Imre Földesi
- Department of Laboratory Medicine, Albert Szent-Gyorgyi Medical School, University of Szeged, H-6720 Szeged, Hungary;
| | - Andrea Surányi
- Department of Obstetrics and Gynecology, Albert Szent-Gyorgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Albert Szent-Gyorgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Gábor Németh
- Department of Obstetrics and Gynecology, Albert Szent-Gyorgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Zoltan Kozinszky
- Capio Specialized Center for Gynecology, Postgången 53, 171 45 Solna, Sweden
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, Albert Szent-Gyorgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.S.); (S.V.); (G.N.); (J.S.)
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Vincze M, Sikovanyecz J, Molnár A, Földesi I, Surányi A, Várbíró S, Németh G, Sikovanyecz J, Kozinszky Z. Predictive Capabilities of Human Leukocyte Antigen-G and Galectin-13 Levels in the Amniotic Fluid and Maternal Blood for the Pregnancy Outcome. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:85. [PMID: 38256346 PMCID: PMC10820789 DOI: 10.3390/medicina60010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/22/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Increasing evidence points to the significant role of the angiogenic factor levels in screening for pregnancy outcome. To examine the potential relationship between concentrations of placental protein 13 (PP13) and soluble human leukocyte antigen-G (sHLA-G) in maternal serum and amniotic fluid at 16-23 weeks of gestation and the sonographic features of pregnancy as well as pregnancy outcome. Materials and Methods: PP13 and sHLA-G in serum and amniotic fluid, fetal biometrical data, and placental volume and perfusion indices were determined in 71 euploid, singleton pregnancies. Results: The serum sHLA-G level exhibits a negative correlation with the serum PP13 level (r = -0.186, p < 0.001) and a positive correlation with the sHLA-G level in amniotic fluid (r = 0.662, p < 0.001). A significant correlation was found between serum sHLA-G level and placental volume (r = 0.142, p < 0.05) and between amniotic sHLA-G level and placental perfusion (r = -0.450, p < 0.001). A low amniotic PP13 level significantly predicted the birth weight (r = -0.102, p < 0.05), the duration of pregnancy (r = -0.155, p < 0.05), and the fetal abdominal circumference (r = -0.098, p < 0.05). Conclusions: PP13 assayed in amniotic fluid might be a potential marker of fetal growth, and sHLA-G can be an adjunct modality reflecting placental sonographic parameters.
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Affiliation(s)
- Márió Vincze
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - András Molnár
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Imre Földesi
- Department of Laboratory Medicine, University of Szeged, H-6720 Szeged, Hungary;
| | - Andrea Surányi
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Gábor Németh
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Zoltan Kozinszky
- Department of Obstetrics and Gynecology, Danderyd Hospital, 182 88 Stockholm, Sweden
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Perkovic-Kepeci S, Cirkovic A, Milic N, Dugalic S, Stanisavljevic D, Milincic M, Kostic K, Milic N, Todorovic J, Markovic K, Aleksic Grozdic N, Gojnic Dugalic M. Doppler Indices of the Uterine, Umbilical and Fetal Middle Cerebral Artery in Diabetic versus Non-Diabetic Pregnancy: Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1502. [PMID: 37629792 PMCID: PMC10456372 DOI: 10.3390/medicina59081502] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/20/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: The aim of this study was to assess the differences in Doppler indices of the uterine (Ut), umbilical (UA), and middle cerebral artery (MCA) in diabetic versus non-diabetic pregnancies by conducting a comprehensive systematic review of the literature with a meta-analysis. Materials and Methods: PubMed, Web of Science, and SCOPUS were searched for studies that measured the pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio index (S/D ratio) of the umbilical artery, middle cerebral artery, and uterine artery in diabetic versus non-diabetic pregnancies. Two reviewers independently evaluated the eligibility of studies, abstracted data, and performed quality assessments according to standardized protocols. The standardized mean difference (SMD) was used as a measure of effect size. Heterogeneity was assessed using the I2 statistic. Publication bias was evaluated by means of funnel plots. Results: A total of 62 publications were included in the qualitative and 43 in quantitative analysis. The UA-RI, UtA-PI, and UtA-S/D ratios were increased in diabetic compared with non-diabetic pregnancies. Subgroup analysis showed that levels of UtA-PI were significantly higher during the third, but not during the first trimester of pregnancy in diabetic versus non-diabetic pregnancies. No differences were found for the UA-PI, UA-S/D ratio, MCA-PI, MCA-RI, MCA-S/D ratio, or UtA-RI between diabetic and non-diabetic pregnancies. Conclusions: This meta-analysis revealed the presence of hemodynamic changes in uterine and umbilical arteries, but not in the middle cerebral artery in pregnancies complicated by diabetes.
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Affiliation(s)
- Sonja Perkovic-Kepeci
- General Hospital Pancevo, 26000 Pancevo, Serbia;
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.K.); (N.M.); (K.M.); (M.G.D.)
| | - Andja Cirkovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.M.); (D.S.)
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.M.); (D.S.)
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA
| | - Stefan Dugalic
- Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (S.D.); (M.M.)
| | - Dejana Stanisavljevic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.M.); (D.S.)
| | - Milos Milincic
- Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (S.D.); (M.M.)
| | - Konstantin Kostic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.K.); (N.M.); (K.M.); (M.G.D.)
| | - Nikola Milic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.K.); (N.M.); (K.M.); (M.G.D.)
| | - Jovana Todorovic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Ksenija Markovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.K.); (N.M.); (K.M.); (M.G.D.)
| | - Natasa Aleksic Grozdic
- Institute for Process Engineering Environmental Engineering and Technical Life Sciences, Technical University of Vienna, 1180 Vienna, Austria;
| | - Miroslava Gojnic Dugalic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.K.); (N.M.); (K.M.); (M.G.D.)
- Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (S.D.); (M.M.)
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Bertholdt C, Dap M, Beaumont M, Duan J, Morel O. New insights into human functional ultrasound imaging. Placenta 2021; 117:5-12. [PMID: 34768169 DOI: 10.1016/j.placenta.2021.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 08/23/2021] [Accepted: 10/06/2021] [Indexed: 12/17/2022]
Abstract
Ultrasound imaging is a vital tool for exploring in vivo the placental function which is essential to understand pathological phenomena such as preeclampsia or intrauterine growth restriction. As technology advances including ready availability of three-dimensional (3D) probes and novel software, new markers of placental function become possible. The objective of this review was to provide an overview of the new ultrasound markers of placental function with a focus on the potential clinical application of three-dimensional power Doppler (3DPD). A broad-free text literature search was undertaken based on human placental studies and sixty full-text studies were included in this review. Three-dimensional power Doppler is a promising technique to predict preeclampsia in the first trimester. However, the influence of external factors such as body mass index, parameter standardisation and machine settings still need to be addressed. Contrast-enhanced ultrasound is currently reserved for research, because the required injected contrast mediums are not currently approved for use in pregnancy, although the safety data is reassuring.
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Affiliation(s)
- C Bertholdt
- Université de Lorraine, CHRU-Nancy, Pôle de Gynécologie-Obstétrique, F-54000 Nancy, France; Université de Lorraine, Inserm, IADI, F-54000 Nancy, France.
| | - M Dap
- Université de Lorraine, CHRU-Nancy, Pôle de Gynécologie-Obstétrique, F-54000 Nancy, France
| | - M Beaumont
- CHRU-Nancy, Inserm, Université de Lorraine, CIC, Innovation Technologique, F-54000 Nancy, France
| | - J Duan
- Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Hubei, 430071, China; Gynecology and Obstetrical Service, Zhongnan Hospital of Wuhan University, Hubei, 430071, China
| | - O Morel
- Université de Lorraine, CHRU-Nancy, Pôle de Gynécologie-Obstétrique, F-54000 Nancy, France; Université de Lorraine, Inserm, IADI, F-54000 Nancy, France
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Kozinszky Z, Altorjay A, Molnar A, Nyári T, Vari SG, Nemeth G, Suranyi A. Ultrasonographic Evaluation of Glycemic Control Effect on Placental Vascularization in Pregnancy with Type 1 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2019; 128:788-795. [PMID: 30641608 DOI: 10.1055/a-0824-6362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIMS The aim of our study was to assess the effect of glycemic control on placental vascularization in pregnancies complicated by type 1 diabetes mellitus (T1DM) and to compare dataset of optimal/suboptimal glycemic control to normal placental 3-dimensional power Doppler (3-DPD) indices in 2nd and 3rd trimester. METHODS Placental vascularization of pregnant women was prospectively evaluated by 3-DPD ((vascularization-index (VI); flow-index (FI); vascularization-flow-index (VFI)) ultrasound technique. The normal pregnancies (n=214) were compared to those complicated by T1DM (n=53) with optimal (HbA1C≤6%;≤ 42 mmol/mol) and suboptimal (HbA1C>6%;>42 mmol/mol) glycemic control. RESULTS Pregnancies complicated by T1DM expressed lower placental vascularization indices as compared with normal pregnancies (adjusted odds ratio (AOR) for VI:0.86; FI:0.94; VFI:0.76). Placental 3-DPD indices have a significant correlation with HbA1C and optimal glycemic control is associated with lower placental perfusion (AOR for VI:1.64; FI:1.13; VFI:2.34). Short-term adverse neonatal outcome was predicted by lower 3-DPD indices (AORVI:0.83, AORFI:0.93, AORVFI:0.66, p<0.05 for each index). Besides the glycemic control, the pregestational body mass index (BMI), had significant influences on placental perfusion. CONCLUSIONS VI displayed the best screening ability for suboptimal glycemic control with a sensitivity of 90.9%. The suboptimal glycemic control has a direct deteriorating effect on placental vasculature. Therefore the ultrasound examination could be an adjunct diagnostic modality for pregnant women with T1DM.
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Affiliation(s)
- Zoltan Kozinszky
- Department of Obstetrics and Gynecology, Blekinge Hospital, Karlskrona, Sweden
| | - AbelT Altorjay
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - Andras Molnar
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - Tibor Nyári
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | - Sandor G Vari
- International Research and Innovation in Medicine Program, Cedars - Sinai Medical Center, Los Angeles, CA, USA
| | - Gabor Nemeth
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - Andrea Suranyi
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
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Sun W, Yin S, Wei Q, Zhang Y, Yang Z, Cai A, Wang Y, Lei W. Three-dimensional power Doppler ultrasound evaluation of placental blood flow in normal monochorionic diamniotic twin pregnancies. BMC Pregnancy Childbirth 2018; 18:443. [PMID: 30428855 PMCID: PMC6237010 DOI: 10.1186/s12884-018-2080-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/31/2018] [Indexed: 01/08/2023] Open
Abstract
Background Monochorionic diamniotic (MCDA) twin pregnancies are at higher risk of adverse outcomes and complications, which are attributed to the influence of placental morphology in MCDA twins. Monitoring of placental function is an important index for clinical decisions. The aim of our study was to evaluate the placental blood flow estimated using three-dimensional power Doppler (3D-PD) ultrasound and the vascular indices distribution with gestational age (GA) in normal MCDA twin pregnancies. Methods One hundred four MCDA twin pregnancies and 106 singleton pregnancies (GA range, 14–32 weeks) were included in this prospective study. 3D-PD volume data of each fetus was obtained separately from the placenta at the site of umbilical cord insertion. We analyzed the volume data using sonobiopsy technique. The placental vascularization index (VI), flow index (FI) and vascularizationflow index (VFI), were auto-calculated. The means and standard deviation values of three vascular indices per fetus were calculated and regression analysis of the vascular indices as a function of GA was performed in twin pregnancies. The vascular indices of twin and singleton pregnancies were compared using independent t-test. Results There were no significant differences in VI, FI or VFI among the fetuses of twins (p > 0.05). These vascular indices increased over the course of pregnancy (p < 0.05). We obtained the regression equations for the indices as a function of GA in days: VI = exp. (4.369–28.533/GA) (R2 = 0.699, p < 0.05), FI = exp. (3.916–13.003/GA) (R2 = 0.511, p < 0.05), and VFI = exp. (3.577–37.468/GA) (R2 = 0.675, p < 0.05). There were no significant differences in three vascular indices between MCDA twin and singleton groups (p > 0.05). Conclusions 3D-PD placental data using sonobiopsy technique could reflect the placental blood flow of each twin, which could be applied to the study of placental perfusion in MCDA twin pregnancies. This study also presented the vascular indices distribution with GA in normal twin pregnancies, which might be useful for early detection of MCDA complications.
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Affiliation(s)
- Wei Sun
- Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shaowei Yin
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qiuju Wei
- Department of Obstetrics and Gynecology, the University of Tennessee Health Science Center, Memphis, TN, USA
| | - Ying Zhang
- Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zeyu Yang
- Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ailu Cai
- Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yu Wang
- Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wenjia Lei
- Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China
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Placental vascularization indices and prediction of pre-eclampsia in high-risk women. Placenta 2018; 70:53-59. [PMID: 30316328 DOI: 10.1016/j.placenta.2018.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 09/05/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assess ability of first and second trimester Placental Vascularization Indices (PVIs) to predict pre-eclampsia (PE) in high-risk pregnancies. METHOD PVIs derived from 3-Dimensional power Doppler imaging were measured at 11+0-13 + 6 (n = 194) and 19+0-21 + 6 weeks (n = 195). Logistic regression (LR) models used PE as the outcome. To quantify added value of PVIs to baseline characteristics in predicting PE, integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices were calculated. RESULTS Overall rate of PE was 12% (n = 26). Lower first trimester PVIs were seen in women with PE (mean, SD); Vascularization Index (VI,%): 10.0 (6.2) v 14.7 (7.6), P = 0.005, Flow Index (FI): 37.7 (9.1) v 42.9 (10.4), P = 0.03, Vascularization Flow Index (VFI): 3.8 (2.5) v 6.6 (4.0), P < 0.001). All first trimester PVIs predicted PE in LR models adjusted for covariates. IDI and NRI analyses confirmed added clinical utility of VI (IDI 0.05, P = 0.004; NRI 0.66, P < 0.001) and VFI (IDI 0.06, P = 0.004; NRI 0.53, P = 0.91). In the second trimester, FI was lower in women with PE (39.6 (9.1) v 44.4 (8.6), P = 0.01) and predicted PE in adjusted LR models (standardised OR 0.53, 95% CI 0.29-0.97, P = 0.04). FI discriminated between cases and non-cases of PE (IDI 0.04, P = 0.04). CONCLUSION First trimester placental vascularization indices (VI, FI and VFI) have the potential to predict PE in high-risk pregnancies, with FI remaining predictive in the second trimester.
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Wong CH, Chen CP, Sun FJ, Chen CY. Comparison of placental three-dimensional power Doppler indices and volume in the first and the second trimesters of pregnancy complicated by gestational diabetes mellitus. J Matern Fetal Neonatal Med 2018; 32:3784-3791. [PMID: 29716432 DOI: 10.1080/14767058.2018.1472226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Objective: To compare the changes of placental three-dimensional power Doppler indices and volume in the first and the second trimesters of pregnancy with gestational diabetes mellitus (GDM). Methods: This was a prospective case-control study of singleton pregnancies with risk factors for GDM. Data on placental vascular indices including vascularization index (VI), flow index (FI), and vascularization flow index (VFI), as well as placental volume were obtained and analyzed during the first and the second trimesters between pregnant women with and without GDM. Results: Of the 155 pregnant women enrolled, 31 developed GDM and 124 did not. VI and VFI were significantly lower in the GDM group during the first and second trimesters (VI: p = .023, and VFI: p = .014 in the first trimester; VI: p = .049, and VFI: p = .031 in the second trimester). However, the placental volume was similar in both the groups during the first trimester, while it was significantly increased in the GDM group during the second trimester (p = .022). There were no significant differences in FI and uterine artery pulsatility index between the two groups. After adjustments in multivariate logistic regression analysis, significant differences were observed in the first trimester VFI (adjusted odds ratio (OR) 0.76, 95% confidence interval (CI) 0.61-0.93), second trimester VFI (adjusted or 0.83, 95%CI 0.71-0.96), and second trimester placental volume (adjusted or 1.03, 95%CI 1.01-1.05). Conclusions: Placental vascular indices can provide an insight into placental vascularization in GDM during early pregnancy. VFI rather than placental volume may be a sensitive sonographic marker in the first trimester of GDM placentas.
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Affiliation(s)
- Chian-Huey Wong
- a Department of Medicine , Mackay Medical College , New Taipei City , Taiwan.,b Department of Obstetrics and Gynecology , Mackay Memorial Hospital , Taipei , Taiwan
| | - Chie-Pein Chen
- a Department of Medicine , Mackay Medical College , New Taipei City , Taiwan.,b Department of Obstetrics and Gynecology , Mackay Memorial Hospital , Taipei , Taiwan
| | - Fang-Ju Sun
- c Department of Medical Research , Mackay Memorial Hospital , Taipei , Taiwan
| | - Chen-Yu Chen
- a Department of Medicine , Mackay Medical College , New Taipei City , Taiwan.,b Department of Obstetrics and Gynecology , Mackay Memorial Hospital , Taipei , Taiwan
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Sun W, Liu J, Zhang Y, Cai A, Yang Z, Zhao Y, Wang Y, Cao Z, Wei Q. Quantitative assessment of placental perfusion by three-dimensional power Doppler ultrasound for twins with selective intrauterine growth restriction in one twin. Eur J Obstet Gynecol Reprod Biol 2018; 226:15-20. [DOI: 10.1016/j.ejogrb.2018.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/08/2018] [Accepted: 05/16/2018] [Indexed: 10/16/2022]
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Altorjay ÁT, Nyári T, Gyurkovits Z, Németh G, Surányi A. Evaluation of placental vascularization indices in monochorionic diamniotic and dichorionic diamniotic twin pregnancies. Eur J Obstet Gynecol Reprod Biol 2018; 228:225-231. [PMID: 30014928 DOI: 10.1016/j.ejogrb.2018.05.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 05/07/2018] [Accepted: 05/31/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We aimed to investigate and compare placental vascularization indices between monochorionic-diamniotic, dichorionic-diamniotic normal twin pregnancies, and normal singular pregnancies. We hypothesized that there is correlation between placental three-dimensional power Doppler vascularization indices and birth weight in case of twin pregnancies, and that normal singular pregnancies have higher placental vascularization indices than normal twin pregnancies. STUDY DESIGN Placental three-dimensional power Doppler vascularization indices, such as vascularization index, flow index, and vascularization-flow index were measured in monochorionic-diamniotic (N = 15) and dichorionic-diamniotic (N = 36) normal twin pregnancies, and in normal singular (N = 109) pregnancies. Correlations were analyzed between vascularization indices, and birth weight, APGAR score, umbilical pH, umbilical venous bicarbonate, lactate, and base excess. RESULTS Vascularization indices and birth weight were significantly (p < 0.01) higher in normal singular gestations (vascularization index = 10.36, flow index = 46.08, vascularization-flow index = 4.08, average birth weight = 3377 g at 38.2 weeks average gestational age) compared to monochorionic-diamniotic and dichorionic-diamniotic normal twin pregnancies. No significant differences were found in vascularization indices between monochorionic-diamniotic and dichorionic-diamniotic normal twins. There were no significant differences in APGAR score, umbilical pH, umbilical venous bicarbonate, lactate, and base excess between groups examined (p < 0.01). We found strong linear correlations between placental vascularization indices and birth weight in both twin groups. CONCLUSION Placental three-dimensional power Doppler vascularization indices seem appropriate for predicting birth weight in monochorionic-diamniotic and dichorionic-diamniotic normal twin pregnancies. Our pilot study revealed reference values for vascularization indices in case of twin pregnancies examined.
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Affiliation(s)
- Ábel Tamás Altorjay
- Szeged, Csongrád, Hungary; Department of Obstetrics and Gynecology, University of Szeged, Faculty of Medicine, Szeged, Hungary.
| | - Tibor Nyári
- Szeged, Csongrád, Hungary; Department of Medical Physics and Informatics, University of Szeged, Faculty of Medicine, Szeged, Hungary.
| | - Zita Gyurkovits
- Szeged, Csongrád, Hungary; Department of Obstetrics and Gynecology, University of Szeged, Faculty of Medicine, Szeged, Hungary
| | - Gábor Németh
- Szeged, Csongrád, Hungary; Department of Obstetrics and Gynecology, University of Szeged, Faculty of Medicine, Szeged, Hungary
| | - Andrea Surányi
- Szeged, Csongrád, Hungary; Department of Obstetrics and Gynecology, University of Szeged, Faculty of Medicine, Szeged, Hungary
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Altorjay ÁT, Surányi A, Nyári T, Németh G. Use of placental vascularization indices and uterine artery peak systolic velocity in early detection of pregnancies complicated by gestational diabetes, chronic or gestational hypertension, and preeclampsia at risk. Croat Med J 2017; 58:161-169. [PMID: 28409499 PMCID: PMC5410734 DOI: 10.3325/cmj.2017.58.161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM We aimed to investigate correlations between uterine artery peak systolic velocity (AUtPSV), and placental vascularization in groups of normal blood pressure (NBP) and hypertensive disorders of pregnancy (chronic hypertension (CHT), gestational hypertension (GHT) and preeclampsia (PE)) alone or in combination with gestational diabetes mellitus (GDM), and hypothesized that AUtPSV rises when GDM complicates pregnancy hypertension. METHODS Placental 3-dimensional power Doppler indices, such as vascularization index (VI), flow index (FI), and vascularization-flow index (VFI), and uterine artery peak systolic velocity (AUtPSV) were measured in CHT (N=43), CHT+GDM (N=15), GHT (N=57), GHT+GDM (N=23) and PE (N=17) pregnancies, and compared to NBP (N=109). Correlations were analyzed between vascularization indices, AUtPSV, pregestational BMI and adverse pregnancy outcome rates. RESULTS In our results VI was higher in CHT (P=0.010), while FI was lower in CHT (P=0.009), GHT and PE (P=0.001) compared to NBP. In case of VFI, significant difference was found between CHT and GHT (P=0.002), and NBP and PE (P=0.001). FI was found prognostic for umbilical pH and neonatal birth weight. Pre-gestational BMI was significantly higher in GHT+GDM compared to GHT, and in CHT+GDM compared to the CHT group. As for AUtPSV, significant difference was found between NBP and CHT (P=0.012), NBP and CHT+GDM (P=0.045), NBP and GHT+GDM (P=0.007), NBP and PE (P=0.032), and GHT and GHT+GDM (P=0.048) groups. CONCLUSION Our study revealed that vascularization indices and AUtPSV show significant differences due to gestational pathology, and can be useful in detection of pregnancies at risk.
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Affiliation(s)
| | - Andrea Surányi
- Andrea Surányi, Semmelweis str. 1., Szeged, Csongrád, H-6725, Hungary,
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Surányi A, Altorjay Á, Kaiser L, Nyári T, Németh G. Evaluation of placental vascularization by three-dimensional ultrasound examination in second and third trimester of pregnancies complicated by chronic hypertension, gestational hypertension or pre-eclampsia. Pregnancy Hypertens 2017; 8:51-59. [DOI: 10.1016/j.preghy.2017.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 01/27/2017] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
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Liu F, Liu Y, Lai YP, Gu XN, Liu DM, Yang M. Fetal Hemodynamics and Fetal Growth Indices by Ultrasound in Late Pregnancy and Birth Weight in Gestational Diabetes Mellitus. Chin Med J (Engl) 2017; 129:2109-14. [PMID: 27569240 PMCID: PMC5009597 DOI: 10.4103/0366-6999.189057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: The offspring of women with gestational diabetes mellitus (GDM) are prone to macrosomia. However, birth weight is difficult to be correctly estimated by ultrasound because of fetal asymmetric growth characteristics. This study aimed to investigate the correlations between fetal hemodynamics, fetal growth indices in late pregnancy, and birth weight in GDM. Methods: A total of 147 women with GDM and 124 normal controls (NC) were enrolled in this study. Fetal hemodynamic indices, including the systolic/diastolic ratio (S/D), resistance index (RI), pulsatility index (PI) of umbilical artery (UA), middle cerebral artery (MCA), and renal artery (RA), were collected. Fetal growth indices, including biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length, were also measured by ultrasound. Birth weight, newborn gender, and maternal clinical data were collected. Results: The independent samples t-test showed that BPD, HC, and AC were larger in GDM than in NC (P < 0.05). Fetal hemodynamic indices of the UA and MCA were lower (P < 0.05), but those of the RA were higher (P < 0.001) in GDM than in NC. Birth weight was higher in GDM than in NC (P < 0.001). Pearson's correlation analysis showed that hemodynamic indices of the UA were negatively correlated with birth weight, BPD, HC, and AC in both groups (P < 0.05). MCA (S/D, PI, and RI) was negatively correlated with birth weight, HC, and AC in GDM (r = −0.164, −0.206, −0.200, −0.226, −0.189, −0.179, −0.196, −0.177, and − 0.172, respectively, P < 0.05), but there were no correlations in NC (P > 0.05). RA (S/D, PI, and RI) was positively correlated with birth weight in GDM (r = 0.168, 0.207, and 0.184, respectively, P < 0.05), but there were no correlations in NC (P > 0.05). Conclusion: Fetal hemodynamic indices in late pregnancy might be helpful for estimating newborn birth weight in women with GDM.
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Affiliation(s)
- Fang Liu
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Yong Liu
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Ya-Ping Lai
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Xiao-Ning Gu
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Dong-Mei Liu
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Min Yang
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
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Farina A. Placental vascular indices (VI, FI and VFI) in intrauterine growth retardation (IUGR). A pooled analysis of the literature. Prenat Diagn 2015; 35:1065-72. [DOI: 10.1002/pd.4646] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 06/24/2015] [Accepted: 06/25/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Antonio Farina
- Division of Obstetrics and Gynecology, Department of Medicine and Surgery (DIMEC); University of Bologna; Bologna Italy
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Surányi A, Kozinszky Z, Molnár A, Németh G. Placental volume relative to fetal weight estimated by sonography in diabetic pregnancies. J Matern Fetal Neonatal Med 2015; 29:1229-32. [DOI: 10.3109/14767058.2015.1040985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Molnár A, Surányi A, Nyári T, Németh G, Pál A. Examination of placental three-dimensional power Doppler indices and perinatal outcome in pregnancies complicated by intrauterine growth restriction. Int J Gynaecol Obstet 2015; 129:5-8. [PMID: 25747494 DOI: 10.1016/j.ijgo.2014.10.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 10/21/2014] [Accepted: 12/23/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine placental vascularization using three-dimensional power Doppler (3DPD) ultrasonography in pregnancies complicated by intrauterine growth restriction (IUGR). METHODS The present prospective study was conducted at the University of Szeged (Szeged, Hungary) from February 2012 to March 2013. Women with a singleton pregnancy who attended the maternity outpatient ward in the second or third trimester were enrolled consecutively. Women were divided into two groups: those with a normal pregnancy and those with a pregnancy complicated by IUGR. Three 3DPD indices-vascularization index (VI), flow index (FI), and vascularization flow index (VFI)-were assessed. RESULTS A total of 223 women were enrolled: 171 were in the control group and 52 in the IUGR group. Median VI was 3.7% (interquartile range [IQR] 3.2%-4.2%) in the IUGR group and 10.1% (IQR 8.6%-10.9%) in the control group (P=0.001). Median FI was 40.0 (IQR 39.7-42.5) in the IUGR group and 45.1 (IQR 44.1-53.1) in the control group (P=0.012). Median VFI was 2.2 (IQR 2.1-2.4) in the IUGR group and 4.8 (IQR 4.4-5.3) in the control group (P<0.001). CONCLUSION Placental vascularization was reduced in pregnancies complicated by IUGR.
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Affiliation(s)
- András Molnár
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary.
| | - Andrea Surányi
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - Tibor Nyári
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - Attila Pál
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
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