Uterine Artery Doppler PI Research Articles

The role of uterine artery colour doppler in intrauterine contraceptive device IUCD – Related Abnormal Uterine Bleeding

This study was conducted to assess the role of Uterine Artery Colour Doppler velocimetry in prediction of intrauterine contraceptive device (IUCD) - Related Abnormal Uterine Bleeding. From this study, we concluded that the initial pre-IUCD insertion measurement of uterine artery Doppler PI and RI indices can be used as an useful predictor in Cu-T associated AUB, thus help in reducing the number of IUCD removal and non-compliance by the patient within the first year of insertion.

Role of sFLT-1/PlGF ratio in predicting severe adverse materno-fetal outcome in high risk women.

To evaluate the role of angiogenic biomarkers in predicting severe adverse materno-fetal outcome (SAO) among women at high risk of preeclampsia (PE). All antenatal women at high risk of PE underwent MAP estimation, sFlt-1/PlGF ratio, uterine artery evaluation at 20-22, 28-30 and 34-36weeks of gestation and were followed until delivery. The severe adverse outcome included severe PE, severe fetal growth restriction with Doppler changes and intrauterine death or early neonatal death. Those who developed SAO were cases and rest were controls, the cases and controls were compared using univariate and multivariate logistic regression analysis. In 54/287(18.8%) SAO was observed, and they comprised of severe PE (21/287, 7.3%), FGR with absent or reverse diastolic flow on Doppler (23/287, 8.0%) and intrauterine death or early neonatal death (10/287, 3.5%). For detecting complications up to 30weeks, the sFLT-1/PlGF ratio at 20weeks (cut off≥38) was the best test (accuracy- 97.6%) followed by MAP and uterine artery Doppler PI. For detecting complications up to 34weeks, prediction was good (accuracy -80.4%) when sFLT-1/PlGF ratio was combined with uterine artery PI. The predictive value of the complications before 34weeks was far superior to that after 34weeks. Combining the sFLT-1/PlGF ratio with the uterine artery PI improved the accuracy of the test (79% to 87%). Increased sFlt-1/PlGF ratio, was a good predictive marker for SAO in the study population. The accuracy of prediction was better for those who developed the complications before 34weeks.

Role of uterine biophysical profile in predicting conception in a sample of infertile women attending an IVF center in Erbil

Background and objective: Failure to get pregnant can be profoundly disappointing, frustrating and eventually lead to a lot of social, medical, and psychological consequences like depression. This study aimed to evaluate the role of uterine biophysical profile in predicting conception in women with a history of infertility. Methods: A prospective diagnostic accuracy study was conducted in Erbil, Iraqi Kurdistan region, in the Maternity Teaching Hospital from October 2019 to September 2020 on 51 women suffering from primary and secondary infertility. Vaginal ultrasound was performed for all the women at mid-cycle and before embryo transfer. The uterine scoring system for reproduction by Applebaum was calculated, and the total score was obtained. Its role in predicting conception was determined. Results: A cut-off of 15 scores of the uterine scoring system for reproduction gave a sensitivity of 86.7% and a specificity of 100%. Factors found to be associated with high rates of pregnancy were endometrial thickness 10-14 mm (P <0.001), distinct trilaminar layer (P <0.001), abundant blood flow within zone 3 (P <0.001), and uterine artery Doppler PI of <2.19 (P <0.001). The last two parameters gave a pregnancy rate of 100%. Conclusion: Applebaum’s uterine scoring system for reproduction is an easy, simple, noninvasive method for predicting pregnancy in women suffering from primary and secondary infertility. Both uterine artery Doppler PI and endometrial receptivity (including thickness, character, and vascularity) are two important parameters in predicting suitable environment for implantation and pregnancy outcome. Keywords: Uterine scoring system for reproduction (USSR); Uterine biophysical profile; In-vitro fertilization (IVF); Intrauterine insemination.

Association of combined second trimester maternal serum Homocysteine and Uterine Artery Doppler to predict adverse pregnancy outcome.

Disturbances in placentation increase the risk of maternal and fetal complications. Several biochemical and imaging modalities have been studied, but the hunt for a single effective screening test never became a reality as the causes of this complex condition are multifactorial and polygenetic, many of which we are only beginning to discover. Not many studies have been conducted in the developing countries like India and other low resource settings to consider whether it would be worthwhile to combine inexpensive and effective markers together for better prediction of adverse pregnancy outcome.This study primarily aims to investigate the predictability of combined screening with maternal serum homocysteine and second trimester uterine artery Doppler in diagnosis of adverse pregnancy outcome. A prospective cohort study which involved 100 women with singleton gestation, meeting the inclusion criteria, attending the inpatient or outpatient of Obstetrics and Gynaecology in Amrita Institute of Medical Sciences, Kerala, a tertiary care centre in Southern India from July 2016 and September 2018 was conducted. Serum Homocysteine estimation (tHcy) was done between 18 and 28weeks of gestation with informed consent, and uterine artery (UA) Doppler PI which is a non-invasive routine study was done along with targeted second trimester anomaly scan (18-24weeks) in Fetal Medicine Department. Cutoff values of tHcy and UA PI were computed at 95th (> / = 9.7mmol/l) and 90th percentile, respectively as reported by Onalan et al. [9] and Nicholaides et al. [4]. Statistical analysis was performed using IBM SPSS version 20.0 software. Chi-square test and diagnostic measures were also used. Of the 100 patients, 15% (n = 15) developed hypertensive disorder. 7% (n = 7) had FGR and 7%(n = 7) had spontaneous preterm birth. 6% (n = 6) neonates had an APGAR score < 7 and 8% neonates (n = 8) required immediate NICU admission. Statistically significant association was found when tHcy and UA PI were used together for the prediction of FGR (p = 0.003), preterm birth (p = 0.002) and low APGAR score at birth (p = 0.009) with a specificity of 83.4%. With regard to PIH, both parameters were found to be statistically significant only when used independently (p = 0.001) but not when used in combination (p = 0.17). Both elevated tHcy and abnormal UA PI used in combination predicted adverse pregnancy outcome like FGR but with a low sensitivity of 14.3% and high specificity of 98.9%. However, when used independently these markers predicted FGR with a better sensitivity (tHcy- 28.6% and UA PI- 44.4%). Findings from this study have been promising with potential clinical implications for the diagnosis and management of high-risk pregnancies. Though the independent role of the two markers in screening various adverse pregnancy outcomes could be proved, their combined use to improve predictivity of more complications warrants further studies on a larger population with appropriate randomisation.

Uterine Artery Doppler and Placental Morphological Features as Predictors of Peripartum Complications in Placenta Previa and Placenta Previa Accreta

Background: Placenta accreta is becoming an increasingly common complication of pregnancy. Placenta accreta originates from abnormal trophoblast invasion. Objective: to assess if uterine artery Doppler and Placental Morphological Features could be predictors of maternal and fetal outcome in pregnancies complicated with placenta previa and placenta previa accreta. Subjects and methods: This study included 80 pregnant women of which they were divided into 3 groups. The first group included 40 pregnant women of normal pregnancies, 2nd one included 20 pregnant women with placenta previa and the 3rd one included 20 pregnant women with suspected placenta previa accreta by ultrasound. Abdominal ultrasound and uterine artery Doppler were done in a week before delivery. Results: There was a direct relationship between presence of lacunae especially high grade, placental vascularity (abnormal) and the mean values of uterine artery PI, RI and presence of peripartum maternal and fetal complications. Conclusion: the gray scale and color Doppler ultrasound have a high diagnostic value in the diagnosis by certain placental morphological features, Including loss of retro-placetal clear zone, thinning of myometrial thickness, Intraplacental lacunae, Intraplacental vascularity and exophytic mass into bladder space. Ultrasound is helpful and non-invasive tool in prediction of maternal and fetal outcome. High grade of placental lacunae and abnormal placental vascularity were highly associated with maternal and fetal complications. Uterine artery Doppler PI and RI is also useful in prediction of maternal complications and fetal complications of placenta previa and placenta previa accreta.

Diagnosis of Placenta Accreta by Uterine Artery Doppler Velicometry in Patients with Placenta Previa

Background: Placenta accreta occurs in the complete or partial absence of the decidua basalis. Women with previous cesarean delivery or placenta previa are known to be at greater risk of placenta accreta. Objectives: to evaluate ultrasound accuracy in diagnosing placenta accreta and its variants and to detect the potential value of uterine artery Doppler in diagnosing placenta accreta and to assess the impact of antenatal diagnosis in Egyptian population. Patients and Methods: This prospective study was conducted on (100) pregnant women diagnosed as placenta previa by ultrasonography and were candidates for either emergency or elective repeated CS or hysterectomy (if the diagnosis of placenta accreta is confirmed). All these patients were randomly selected from the Obstetrics Clinic at Beni-Suef General Hospital during their 3rd trimester. The study was approved by the medical ethics committee of Al-Azhar University academic and ethical committee and a written informed consent was obtained from all patients. Results: The results obtained from this study indicated no statistically significant differences regarding the mean values of uterine artery Doppler PI and RI between cases of placenta accreta and non accreta (p value =.078 & 0.58 respectively) in correlation with histopathological assessment. Our results showed no statistically significant correlation regarding mean values of uterine artery Doppler PI and RI between cases of placenta accreta and placenta non accreta (p values = 0.341, 0.953 respectively) in correlation with intra-operative assessment. Conclusion: Several ultrasound criteria can be used in diagnosis of placenta accreta, as this study showed their high accuracy. They include loss of retroplacental clear zone, presence of abnormal placental lacunae, myometrial thinning and utero-vesical hypervascularity. On the other hand, both loss of retroplacental clear zone, abnormal placental lacunae can predict which patient will mostly have CS hysterectomy.

Diagnosis of Placenta Accreta by Uterine Artery Doppler Velicometry in Patients with Placenta Previa

Background: Placenta accreta occurs in the complete or partial absence of the decidua basalis. Women with previous cesarean delivery or placenta previa are known to be at greater risk of placenta accreta. Objectives: to evaluate ultrasound accuracy in diagnosing placenta accreta and its variants and to detect the potential value of uterine artery Doppler in diagnosing placenta accreta and to assess the impact of antenatal diagnosis in Egyptian population. Patients and Methods: This prospective study was conducted on (100) pregnant women diagnosed as placenta previa by ultrasonography and were candidates for either emergency or elective repeated CS or hysterectomy (if the diagnosis of placenta accreta is confirmed). All these patients were randomly selected from the Obstetrics Clinic at Beni-Suef General Hospital during their 3rd trimester. The study was approved by the medical ethics committee of Al-Azhar University academic and ethical committee and a written informed consent was obtained from all patients. Results: The results obtained from this study indicated no statistically significant differences regarding the mean values of uterine artery Doppler PI and RI between cases of placenta accreta and non accreta (p value =.078 & 0.58 respectively) in correlation with histopathological assessment. Our results showed no statistically significant correlation regarding mean values of uterine artery Doppler PI and RI between cases of placenta accreta and placenta non accreta (p values = 0.341, 0.953 respectively) in correlation with intra-operative assessment. Conclusion: Several ultrasound criteria can be used in diagnosis of placenta accreta, as this study showed their high accuracy. They include loss of retroplacental clear zone, presence of abnormal placental lacunae, myometrial thinning and utero-vesical hypervascularity. On the other hand, both loss of retroplacental clear zone, abnormal placental lacunae can predict which patient will mostly have CS hysterectomy.

D4. MCA/UtA ratio at first observation is associated with birthweight in late onset IUGR

Introduction: MCA and uterine artery Doppler PI are commonly used in the evaluation of IUGR.Targets: This retrospective pilot study aims to investigate whether MCA/UtA ratio may identify adverse outcome in late onset IUGRs. A cohort of 69 pregnancies affected with late IUGR which underwent labor induction according to local protocols was retrospectively revised on the relationship between MCA/UtA ratio at first observation and the following adverse outcomes: cesarean section for nonreassuring fetal status, birthweight (expressed as percentile and continuous values, umbilical artery pH, NICU admission and Apgar score < 7 after 1 and 5 min.Results: The study population included 75.4% nulliparous women. Mean gestational age was 36.7 and 38.7 weeks’ gestation for diagnosis and induction, respectively. MCA/UtA ratio resulted significantly associated with a lower trend in birthweight, with a variation of 109.72 g for each unit considered (p = 0.040). The other outcomes considered showed no association.Conclusions: MCA/UtA ratio at first observation may be associated with lower birthweight in late onset IUGRs. Further prospective studies are expected.

Role of maternal factors, PAPP-A, and Doppler in screening for early- and late-onset pregnancy hypertension in Asian population

ABSTRACTObjective: To determine the predictive value of biochemical markers, uterine artery Doppler, and maternal factors in predicting early-onset (EO) and late-onset (LO) pregnancy hypertension. Methodology: All singleton pregnancies between 11 and 13 weeks and 6 days gestation underwent estimation of body mass index (BMI), mean arterial pressure (MAP), uterine artery Doppler pulsatality index (PI, and resistance index), biomarker PAPP-A, and free β-hCG. Women who developed hypertension were treated as cases and normotensives were taken as controls. The cases were further divided into EO and LO hypertension. The comparison was undertaken by appropriate statistical analysis. Results: Pregnancy hypertension was seen in 399 (13.2%) women. EO hypertension was seen in 153 (38.3%), whereas LO was observed in 246 (61.7%). The significant markers for predicting hypertension in pregnancy were maternal age, BMI, MAP, uterine artery Doppler PI, and PAPP-A. A combination of MAP and BMI was a better predictor (sensitivity and specificity 80% and 52%, respectively) than PAPP-A and Doppler combined (sensitivity and specificity 62% and 52%, respectively). When all the above markers were combined, the sensitivity and specificity of the test was 73% and 70%, respectively. EO hypertension was better predicted compared with LO. The negative predictive value (NPV) of the test was above 90%, suggesting that if a woman had the marker below the cutoff, there was more than 90% chance that she would not develop hypertension later in pregnancy. Conclusion: A combination of variables increased the sensitivity and specificity of the test for hypertension in pregnancy. The markers examined were a predictor of EO hypertension, with a high NPV, making it a good screening test.

Placental growth factor and soluble fms-like tyrosine kinase-1 are useful markers for the prediction of preeclampsia but not for small for gestational age neonates: a longitudinal study

ObjectiveTo determine maternal serum concentrations of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) longitudinally in normal pregnancies, pregnancies that developed preeclampsia and pregnancies that deliver a small for gestational age (SGA) infant, in order to evaluate them as markers for the prediction of preeclampsia. Study designIn this case–control study we included 12 singleton pregnancies that developed preeclampsia and 104 randomly selected singleton normal pregnancies. Fourteen of the normal pregnancies gave birth to an SGA infant. Blood samples and ultrasonographic data were collected during the 1st, 2nd and 3rd trimesters of pregnancy. ResultsIn preeclamptic pregnancies, PlGF (pg/mL) (median; inter-quartile range) was significantly lower in the 2nd (208; 84–339) (p=0.035) and in the 3rd trimester (202; 109–284) (p=0.002) while sFlt-1 was significantly higher only in the 3rd trimester (2521; 2101–3041) (p=0.011) compared to normal pregnancies (PlGF 2nd: 311; 243–440, PlGF 3rd: 780; 472–1037, sFlt-1 3rd: 1616; 1186–2220). In pregnancies with SGA infants, PlGF and sFlt-1 did not differ significantly from normal pregnancies in any trimester. The sFlt-1 to PlGF ratio was significantly higher in preeclamptic pregnancies than in normal pregnancies, in both the 2nd and 3rd trimesters. The relative difference and the slope of PlGF concentration between 1st and 2nd trimester were significantly reduced in preeclampsia compared to normal pregnancies. A logistic regression model with predictors BMI, 2nd trimester Doppler PI and relative difference of PlGF from the 1st to the 2nd trimester gave 46% sensitivity and 99% specificity for the prediction of preeclampsia, with a very high negative predictive value of 98.3%. ConclusionsOur study confirms that maternal serum PlGF concentration is significantly lower, at least after 20th week, while sFlt-1 concentration is significantly higher in 3rd trimester, in pregnancies destined to develop preeclampsia. Pregnancies that gave birth to SGA infants do not have altered angiogenic factor concentrations throughout pregnancy. The relative difference of PlGF from the 1st to the 2nd trimester, uterine artery Doppler PI in the 2nd trimester and BMI are the most powerful markers for the prediction of preeclampsia.

369: Second trimester placental growth in the prediction of adverse pregnancy outcomes

As the placenta plays a central role in many adverse pregnancy outcomes, we sought to investigate the utility of 3-dimensional (3D) sonographic measures of second trimester placental growth as predictors of intrauterine growth restriction and pregnancy related hypertension (PRH). We conducted a prospective cohort study investigating the role of 3D placental ultrasound in the prediction of adverse pregnancy outcomes. In order to focus on 2nd trimester placental growth, this analysis was limited to subjects with a 3D volume available at both 11-14 weeks and 18-24 weeks. The VOCAL application of 4DVIEW (GE) was used to calculate placental volume (PV) which was normalized to gestational age to yield placental quotient (PQ). Then, the maternal surface of the placenta was measured every 45 degrees around the circumference; the mean of these 4 values, mean placental diameter (MPD), represents the surface area of the utero-placental interface. The rate of placental growth from 1st to 2nd trimester was analyzed as volume change per week (VOL/WK). These variables, as well as mean uterine artery Doppler PI (UPI), were analyzed as predictors of SGA10 (birthweight <10th %ile), SGA5 (<5th %ile) and PRH. Of 257 subjects, 26 (10.1%) were SGA10, 13 (5.1%) were SGA5 and 32 (12.5%) developed PRH. Mean PV, PQ and MPD were all significantly lower for both SGA10 and SGA5 compared to non-SGA subjects. VOL/WK was significantly lower for SGA10, but not SGA5. The AUCs demonstrated moderate predictive value for SGA10 and SGA5 (Table). The sonographic parameters were not significant predictors of PRH. In this cohort, UPI was not predictive of either SGA or PRH.Tabled 1Prediction of SGA by placental 3D ultrasound parameters Placental size and growth in the 2nd trimester are significantly associated with the development of SGA. Further investigation is needed to determine whether such measurements can be useful in the early prediction of intrauterine growth restriction.

PP143. Relationship between mid-pregnancy placenta growth factor and hemodynamics in the mother, fetus, and uterus

Placental Growth Factor (PlGF) is an angiogenic and vasoregulatory peptide member of the vascular endothelial growth factor family. Reduction of free, circulating PlGF is associated with preeclampsia and fetal growth restriction, and precedes the clinical manifestations of disease by several weeks. It is not known whether aberrant PlGF is related for alterations in endothelial vascular function that cause or exacerbate the placental syndromes of pregnancy. We sought to determine if mid-pregnancy PlGF was related to, and possibly mediating, measures of maternal, fetal, or uterine hemodynamic function in women at risk for placenta-mediated complications of pregnancy. We measured free plasma PlGF (Triage PlGF Assay, Alere, Inc.) between 22 and 25 weeks in high risk subjects referred for assessment of fetal growth and uterine artery Dopplers due to abnormalities of serum screening analytes or other risk factors for preeclampsia. Maternal hemodynamic parameters including mean arterial pressure (MAP), cardiac index (CI), systemic vascular resistance (SVR) and index of contractility (ICON) were measured in recumbent position with noninvasive electrical cardiography (Aesculon EC System, Cardiotronics, Inc.). Doppler measurements of blood flow in the uterine arteries (pulsatility index, PI) and umbilical artery (systolic:diastolic ratio, S/D) were obtained by ultrasound (Voluson E8, GE Healthcare, Inc.), along with the estimated fetal weight (EFW). PlGF was expressed as the log concentration, plotted against the hemodynamic measurements, and analyzed with Spearman's correlation coefficient, R. Statistical significance was set to p=0.05. Data from seventeen fully studied patients were analyzed. The median gestational age was 24.3 weeks. PlGF concentration ranged from 25 to 1180 with a median of 235pg/ml. PlGF was positively related to maternal cardiac index (R=0.56, p=0.02) and ICON (R=0.51, p=0.04) and negatively related to SVR (R=-0.48, p=0.05). There was a non-significant negative correlation with MAP (R=-0.41, p=0.10). PlGF showed a positive correlation to EFW (R=0.52, p=0.03) and a negative relationship to umbilical artery S/D ratio (R=-0.42,p=0.06). There was no correlation between maternal PlGF and uterine artery Doppler PI (R=-0.19, p=0.46). The concentration of circulating free PlGF at mid-pregnancy is related to both maternal systemic hemodynamic function and fetal umbilical artery resistance (and growth) in high risk pregnancies prior to the onset of preeclampsia. It is not, however, related to vascular resistance in the uterine artery. PlGF may play a role in modulating the general vascular function of the fetus and mother after establishment of the uteroplacental circulation.

OP16.09: Relationship between uterine artery Doppler PI and platelet aggregation in women at risk of preeclampsia

OP16.09: Relationship between uterine artery Doppler PI and platelet aggregation in women at risk of preeclampsia

OP27.10: Relationship between uterine artery Doppler PI and augmentation index in women at risk of pre‐eclampsia

for gestational age. The correlation coefficient (CC) between the two techniques and between each techniques and mid-trimester findings was calculated using non-parametric analysis (Spearman rho). Results: Out of 81 women that were recruited, first trimester Doppler was achievable for both arteries in 81 (100%) with technique 1 and in 66 (82%) for technique 2 (P < 0.01). Correlation analyses were performed using the women with available data for both techniques. The correlation for mean PI between the two techniques was only moderate (CC: 0.67). Moreover, first trimester PI correlates better with mid-trimester PI using technique 1 (CC: 0.77) than technique 2 (CC: 0.55). Inter-observer reproducibility (n = 34) was also better with technique 1 than with technique 2 (CC: 0.86 vs. 0.71). Conclusions: First-trimester uterine artery Doppler performed at the level of internal cervical os from its ascending branch is more easily obtained than when it is performed at the level of the apparent crossover with external iliac vessels. Moreover, its PI correlates better with the mid-trimester PI than the second technique.

OP27.08: Relationship between uterine artery Doppler PI and maternal heart rate in women at risk of preeclampsia

OP27.08: Relationship between uterine artery Doppler PI and maternal heart rate in women at risk of preeclampsia

OP09.08: Relationship between uterine artery Doppler PI and P‐selectin expression in women at risk of preeclampsia

OP09.08: Relationship between uterine artery Doppler PI and P‐selectin expression in women at risk of preeclampsia

OP27.11: Relationship between uterine artery Doppler PI and pulse wave velocity in women at risk of pre‐eclampsia

OP27.11: Relationship between uterine artery Doppler PI and pulse wave velocity in women at risk of pre‐eclampsia

Screening for Pre-eclampsia–Lessons from Aneuploidy Screening

Background Antenatal screening for aneuploidy is an established routine clinical practice worldwide. The same statistical methodology, developed and refined over three decades, might be adapted to screening for pre-eclampsia. Methods The published literature is reviewed for evidence that the methodology is valid for pre-eclampsia using first trimester maternal serum PP13, PAPP-A, PlGF, ADAM12 and inhibin A, together with MAP and uterine artery Doppler PI. Risk is estimated for both early onset pre-eclampsia, requiring delivery before 34 weeks, or late onset disease. Prior risk from the background prevalence multiplied by likelihood ratios (LRs) for ethnicity, parity, adiposity and family history is multiplied by an LR from the screening marker profile. Markers are expressed in multiples of the gestation-specific median and adjusted for body mass, ethnicity and smoking status as appropriate. A standardized population with a fixed distribution of risk factors and a multi-variate Gaussian model of marker profiles is used to predict performance. Results There is sufficient published data to estimate individual risks reasonably well. Modeling predicts that using PAPP-A and one other serum marker, together with the physical markers more than two-thirds of early and one-third of late onset cases can be detected by classifying less than 2% of pregnancies as high risk; three-quarters of early case could be detected with a 5% high risk rate. Conclusion Whilst more data on some markers is still required modeling so far suggests that extending first trimester aneuploidy screening programs to include pre-eclampsia screening would yield a high detection. However, prospective studies are needed to verify the model predictions.

Fibronectin, Plasminogen Activator Inhibitor Type 1 (PAI-1) And Uterine Artery Doppler Velocimetry as Markers of Preeclampsia

Objective: The purpose of this study was to examine plasma levels of fibronectin and plasminogen inhibitor type 1 (PAI-1), and alterations in uterine artery (UtA) waveforms throughout normotensive and preeclamptic pregnancies and to analyze its predictive value for the detection of preeclampsia within the second trimester of pregnancy.Material and methods: Blood samples were collected from 102 healthy, nulliparous women between the 24th and 26th gestational week. Preeclampsia developed in 13 patients; 89 normotensive control subjects were matched from the same cohort. Plasma samples were assayed for fibronectin and PAI-1 by enzyme-linked immunosorbent assay. Color pulsed Doppler examinations of UtA were performed after blood sampling. Trends were compared between two groups.Results: Maternal plasma fibronectin and PAI-1 levels and average PI, RI and S/D ratios of patients with preeclampsia were significantly higher (p &lt; 0.05). The best cut-off values for predicting preeclampsia of fibronectin, PAI-1, PI, RI, S/D ratio based on ROC curve analysis were 290 mg/ml, 77.3 ng/ml, 1,0615, 0.605 and 2,59 respectively. The areas under the curve equal to 0.705, 0.753, 0.689, 0.695 and 0.699 for fibronectin, PAI-1 and uterine artery Doppler PI, RI, S/D ratio were determined for the prediction of preeclampsia.Conclusions: Fibronectin, PAI-1 and UtA Doppler are potentially useful predictors of preeclampsia. Maternal plasma PAI-1 combinated with fibronectin had the highest predictive values in our study.

Fibronectin, plasminogen activator inhibitor type 1 (PAI-1) and uterine artery Doppler velocimetry as markers of preeclampsia.

Objective: The purpose of this study was to examine plasma levels of fibronectin and plasminogen inhibitor type 1 (PAI-1), and alterations in uterine artery (UtA) waveforms throughout normotensive and preeclamptic pregnancies and to analyze its predictive value for the detection of preeclampsia within the second trimester of pregnancy. Material and methods: Blood samples were collected from 102 healthy, nulliparous women between the 24th and 26th gestational week. Preeclampsia developed in 13 patients; 89 normotensive control subjects were matched from the same cohort. Plasma samples were assayed for fibronectin and PAI-1 by enzyme-linked immunosorbent assay. Color pulsed Doppler examinations of UtA were performed after blood sampling. Trends were compared between two groups. Results: Maternal plasma fibronectin and PAI-1 levels and average PI, RI and S/D ratios of patients with preeclampsia were significantly higher (p < 0.05). The best cut-off values for predicting preeclampsia of fibronectin, PAI-1, PI, RI, S/D ratio based on ROC curve analysis were 290 mg/ml, 77.3 ng/ml, 1,0615, 0.605 and 2,59 respectively. The areas under the curve equal to 0.705, 0.753, 0.689, 0.695 and 0.699 for fibronectin, PAI-1 and uterine artery Doppler PI, RI, S/D ratio were determined for the prediction of preeclampsia. Conclusions: Fibronectin, PAI-1 and UtA Doppler are potentially useful predictors of preeclampsia. Maternal plasma PAI-1 combinated with fibronectin had the highest predictive values in our study.