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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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Abe M, Arima H, Yoshida Y, Fukami A, Sakima A, Metoki H, Tada K, Mito A, Morimoto S, Shibata H, Mukoyama M. Optimal blood pressure target to prevent severe hypertension in pregnancy: A systematic review and meta-analysis. Hypertens Res 2022; 45:887-899. [PMID: 35136186 DOI: 10.1038/s41440-022-00853-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/25/2021] [Accepted: 12/31/2021] [Indexed: 12/25/2022]
Abstract
Severe hypertension in pregnancy is a hypertensive crisis that requires urgent and intensive care due to its high maternal and fetal mortality. However, there is still a conflict of opinion on the recommendations of antihypertensive therapy. This study aimed to identify the optimal blood pressure (BP) levels to prevent severe hypertension in pregnant women with nonsevere hypertension. Ovid MEDLINE and the Cochrane Library were searched, and only randomized controlled trials (RCTs) were included if they compared the effects of antihypertensive drugs and placebo/no treatment or more intensive and less intensive BP-lowering treatments in nonsevere hypertensive pregnant patients. A random effects model meta-analysis was performed to estimate the pooled risk ratio (RR) for the outcomes. Forty RCTs with 6355 patients were included in the study. BP-lowering treatment significantly prevented severe hypertension (RR, 0.46; 95% CI, 0.37-0.56), preeclampsia (RR, 0.82; 95% CI, 0.69-0.98), severe preeclampsia (RR, 0.38; 95% CI, 0.17-0.84), placental abruption (RR, 0.52; 95% CI, 0.32-0.86), and preterm birth (< 37 weeks; RR, 0.81; 95% CI, 0.71-0.93), while the risk of small for gestational age infants was increased (RR, 1.25; 95% CI, 1.02-1.54). An achieved systolic blood pressure (SBP) of < 130 mmHg reduced the risk of severe hypertension to nearly one-third compared with an SBP of ≥ 140 mmHg, with a significant interaction of the BP levels achieved with BP-lowering therapy. There was no significant interaction between the subtypes of hypertensive disorders of pregnancy and BP-lowering treatment, except for placental abruption. BP-lowering treatment aimed at an SBP < 130 mmHg and accompanied by the careful monitoring of fetal growth might be recommended to prevent severe hypertension.
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Affiliation(s)
- Makiko Abe
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
| | - Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Oita, Japan
| | - Ako Fukami
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Atsushi Sakima
- Health Administration Center, University of the Ryukyus, Okinawa, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Kazuhiro Tada
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Asako Mito
- Division of Maternal Medicine, Center for Maternal-Fetal-Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Satoshi Morimoto
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masashi Mukoyama
- Department of Nephrology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
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Hasija A, Balyan K, Debnath E, V R, Kumar M. Prediction of hypertension in pregnancy in high risk women using maternal factors and serial placental profile in second and third trimester. Placenta 2021; 104:236-242. [PMID: 33450643 DOI: 10.1016/j.placenta.2021.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/11/2020] [Accepted: 01/05/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION To evaluate the role of placental profile markers in second and third trimester of pregnancy in predicting hypertensive disorders of pregnancy (HDP) in women at high risk of preeclampsia. METHOD Women who were at high risk of preeclampsia underwent βhCG, ultrasound assessment of placental length, thickness and its ratio, uterine artery Doppler at 20-24 weeks and 28-32 weeks of gestation, the outcome at delivery was noted. Those who developed HDP were cases and those with normal outcome were controls. The placental profile markers among cases and controls were compared. RESULTS Hypertensive disorders of pregnancy was seen in 72/160 (45%) high risk women The serum β hCG levels at 20-24 weeks (p = 0.001) and 28-32 weeks (p = 0.018) was significantly high in women who had preeclampsia. Placental thickness was found to be less in among all subgroups of HDP, for preeclampsia, it was significantly low at 20-24 weeks (AUC- 0.743; sensitivity- 75%, specificity- 66.3%) and 28 weeks (AUC -0.764, sensitivity - 75.0% specificity - 78.7%). Uterine artery S/D ratio was considerable high in women with chronic hypertension (AUC -0.765), gestational hypertension (AUC -0.771) and preeclampsia (AUC -0.726) at 20-24 weeks. In preeclampsia group, uterine artery PI was highest and the best marker at 20-24 weeks (AUC -0.935, sensitivity - 100.0%, specificity - 87.6%). DISCUSSION The placental profile markers may be used to provide closer follow up in high risk pregnancies with abnormal placental profile levels, while less intense follow up in those with normal levels, thus channelizing the resources.
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Affiliation(s)
- Aayushi Hasija
- Department of Obstetrics and Gynecology, LHMC, New Delhi, India
| | - Kirti Balyan
- Department of Obstetrics and Gynecology, LHMC, New Delhi, India
| | - Ekta Debnath
- Department of Biochemistry, LHMC, New Delhi, India
| | - Ravi V
- Department of Statistics, LSR, New Delhi, India
| | - Manisha Kumar
- Department of Obstetrics and Gynecology, LHMC, New Delhi, India.
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Elhelaly AM, Elnaggar AK, Mohamed MEDM, Abdelfattah MH, Farag AH. First trimester placental volume and vascular indices in pregestational diabetic compared to nondiabetic pregnant women. J Obstet Gynaecol Res 2020; 46:1326-1332. [PMID: 32585732 DOI: 10.1111/jog.14271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/13/2020] [Accepted: 04/09/2020] [Indexed: 12/11/2022]
Abstract
AIM Comparing placental volume (PV) and vascular indices in pregestational diabetic and nondiabetic pregnant women at 11 and 13 weeks gestation. METHODS A case-control study conducted at Ain Shams University Maternity Hospital in collaboration with Feto-maternal Unit for Ultrasound Assessment, Ain Shams University Maternity Hospital, Egypt. Ninety-two pregnant women divided into two groups: Group A included 46 women with pregestational diabetes mellitus and group B included 46 nondiabetic pregnant women as control. All participants had PV, vascularization index (VI), flow index (FI) and vascularization flow index (VFI) calculated using three-dimensional (3D) ultrasonography and 3D power Doppler at 11 and 13 weeks of pregnancy. RESULTS At 11 weeks, the mean VI, FI and VFI in diabetic group (17.70 ± 12.62, 40.72 ± 11.03 and 7.77 ± 6.37, respectively) were insignificantly higher than in nondiabetic group (12.14 ± 12.62, 34.59 ± 9.66 and 6.52 ± 14.20, respectively) while mean PV in diabetic group (26.90 ± 14.74) was insignificantly lower than in nondiabetic group (27.53 ± 17.46). Also at 13 weeks, the results were not different as the mean VI, FI and VFI in diabetic group (16.51 ± 9.81, 42.52 ± 7.47 and 8.12 ± 7.55, respectively) were insignificantly higher than in nondiabetic group (16.37 ± 14.17, 40.29 ± 17.52 and 7.08 ± 4.35, respectively), and mean PV in diabetic group (52.04 ± 17.95) was insignificantly lower than in nondiabetic group (54.46 ± 17.85). There was strong positive correlation between HbA1C level and VFI measured at 13 weeks gestation. CONCLUSIONS Placental indices in early pregnancy do not seem to be useful markers to anticipate placental pathology in pregestational diabetes, however there might be a role for HbA1C level measurement to anticipate such complications.
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Affiliation(s)
- Amr M Elhelaly
- Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Cairo, Egypt
| | - Ahmed K Elnaggar
- Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Cairo, Egypt
| | - Magd El Din M Mohamed
- Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Cairo, Egypt
| | - Mahmoud H Abdelfattah
- Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Cairo, Egypt
| | - Amr H Farag
- Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Cairo, Egypt.,Department of Obstetrics and Gynecology, Walsall Manor Hospital, Walsall, UK
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Zhang L, Liu X, Li J, Wang X, Huang S, Luo X, Zhang H, Wen L, Tong C, Saffery R, Yan J, Qi H, Kilby MD, Baker PN. Maternal Utero-Placental Perfusion Discordance in Monochorionic-Diamniotic Twin Pregnancies with Selective Growth Restriction Assessed by Three-Dimensional Power Doppler Ultrasound. Med Sci Monit 2020; 26:e919247. [PMID: 31971163 PMCID: PMC6996265 DOI: 10.12659/msm.919247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background The aim of this study was to assess the correlation between selective growth restriction (sGR) and co-twin utero-placental perfusion discordance by using three-dimensional power Doppler (3DPD). Material/Methods We prospectively recruited 60 sGR and 64 normal monochorionic-diamniotic (MCDA) twin pregnancies. Vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were assessed by 3DPD, while umbilical artery pulsatility index (UA-PI), middle cerebral artery peak systolic velocity (MCA-PSV), pulsatility index (MCA-PI), and cerebroplacental ratio (CPR) were assessed by conventional Doppler imaging. Results In sGR co-twins, the VI, FI, VFI, MCA-PI, and CPR were significantly lower, while the UA-PI and MCA-PSV were significantly greater, in the smaller fetuses compared with the larger fetuses; significant differences were also observed in the VI, FI, VFI, CPR, and UA-PI in normal co-twins. Compared with the appropriately grown twins, the discordances of the VI, FI, VFI, UA-PI, MCA-PI, and CPR were increased in the sGR cohort. The discordances of the VI, FI, VFI, UA-PI, MCA-PI, and CPR were associated with birthweight discordance, and the FI discordance and CPR discordance were independently associated with sGR. The combination of the FI and CPR discordance showed a higher predictive accuracy for sGR, with an area under the ROC curve of 0.813, and a sensitivity and specificity of 68.33% and 85.94%, respectively. Conclusions MCDA twin pregnancies with birthweight discordance presented utero-placental perfusion deterioration assessed by 3DPD prior to sGR diagnosis. Co-twin utero-placental perfusion discordance was significantly correlated with growth discordance, and this correlation was more predictive of sGR when 3DPD was combined with conventional Doppler imaging.
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Affiliation(s)
- Lan Zhang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,Fetal Medicine Unit, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,International Collaborative Joint Laboratory of Reproduction and Development of Ministry of Education P.R.C., Chongqing Medical University, Chongqing, China (mainland).,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Xiyao Liu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,International Collaborative Joint Laboratory of Reproduction and Development of Ministry of Education P.R.C., Chongqing Medical University, Chongqing, China (mainland).,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Junnan Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,Fetal Medicine Unit, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,International Collaborative Joint Laboratory of Reproduction and Development of Ministry of Education P.R.C., Chongqing Medical University, Chongqing, China (mainland).,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Xing Wang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,Fetal Medicine Unit, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,International Collaborative Joint Laboratory of Reproduction and Development of Ministry of Education P.R.C., Chongqing Medical University, Chongqing, China (mainland).,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Shuai Huang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,Fetal Medicine Unit, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,International Collaborative Joint Laboratory of Reproduction and Development of Ministry of Education P.R.C., Chongqing Medical University, Chongqing, China (mainland).,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Xiaofang Luo
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,International Collaborative Joint Laboratory of Reproduction and Development of Ministry of Education P.R.C., Chongqing Medical University, Chongqing, China (mainland).,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Hua Zhang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,International Collaborative Joint Laboratory of Reproduction and Development of Ministry of Education P.R.C., Chongqing Medical University, Chongqing, China (mainland).,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Li Wen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,International Collaborative Joint Laboratory of Reproduction and Development of Ministry of Education P.R.C., Chongqing Medical University, Chongqing, China (mainland).,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Chao Tong
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,International Collaborative Joint Laboratory of Reproduction and Development of Ministry of Education P.R.C., Chongqing Medical University, Chongqing, China (mainland).,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Richard Saffery
- Cancer, Disease and Developmental Epigenetics, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Pediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Jianying Yan
- Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Hongbo Qi
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,International Collaborative Joint Laboratory of Reproduction and Development of Ministry of Education P.R.C., Chongqing Medical University, Chongqing, China (mainland).,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Mark D Kilby
- Institute of Metabolism and System Research, University of Birmingham, Edgbaston, United Kingdom.,Fetal Medicine Centre, Birmingham Women's and Children's Foundation Trust, Birmingham, United Kingdom
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, United Kingdom
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Abstract
Gestational hypertension, preeclampsia, and peripartum cardiomyopathy are among the most common and often severe pregnancy-specific cardiovascular diseases (CVDs) and causes of complications in pregnancy. This clinical review provides nurses with an overview of pregnancy-specific CVDs, outlines their pathophysiology, and discusses risk factors and assessment. It describes management interventions according to timing: the antepartum, intrapartum, and postpartum phases are each addressed.
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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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