RESUMEN
OBJECTIVES: PIH and IUGR are serious complications in the third trimester of pregnancy. Many publications claim a connection between false positive prenatal tests and subsequent occurrence of PIH and IUGR. DESIGN: The aim of the study was to estimate the usefulness of the biochemical markers of fetal defects and uterine Doppler examination in predicting PIH and IUGR in the third trimester of pregnancy. METHODS: We examined 156 pregnant patients in The Department of the Fetal Medicine and Gynecology Medical University of Lodz, between 2006-2009. In case of each pregnant woman we estimated biochemical markers in the first (PAPP-A + beta-hCG) and second trimester (AFP, beta-hCG, uE3 - triple test). Each patient underwent three ultrasonographic examinations in the first, second and third trimester (between 11-13, 15-20, and 22-27 weeks gestation, respectively) with uterine artery Doppler examination. We monitored these pregnancies for PIH and IUGR and divided them into three groups: 28 patients with PIH (study group 1), 14 patients with IUGR (study group 2), and 114 patients with uncomplicated pregnancies (controls). RESULTS: In both study groups we observed: higher concentration of beta-hCG, higher percentage of the positive biochemical prenatal tests and abnormal uterine artery Doppler waveform. Positive triple test was the strongest predictor of PIH and IUGR (PPV=60.87% for PIH and PPV = 30.77% for IUGR). CONCLUSIONS: Biochemical markers and abnormal uterine artery Doppler waveform are associated with PIH and IUGR. These parameters can be the base for the test identifying pregnant patients with high risk of PIH and IUGR.
Asunto(s)
Retardo del Crecimiento Fetal/diagnóstico por imagen , Hipertensión Inducida en el Embarazo/diagnóstico por imagen , Diagnóstico Prenatal/métodos , Arterias Umbilicales/diagnóstico por imagen , Útero/diagnóstico por imagen , Adulto , Biomarcadores/sangre , Gonadotropina Coriónica/sangre , Estudios de Cohortes , Femenino , Retardo del Crecimiento Fetal/sangre , Humanos , Hipertensión Inducida en el Embarazo/sangre , Placenta/irrigación sanguínea , Placenta/fisiopatología , Embarazo , Tercer Trimestre del Embarazo , Pronóstico , Sensibilidad y Especificidad , Proteína Estafilocócica A/sangre , Ultrasonografía Doppler en Color , Ultrasonografía Prenatal/métodos , Arterias Umbilicales/fisiopatología , Útero/irrigación sanguínea , Adulto Joven , alfa-Fetoproteínas/análisisRESUMEN
Modern, non-invasive prenatal diagnostics based on biochemical and ultrasonographic markers of fetal defects allows us to calculate the risk of fetal chromosomal aneuploidies with high sensitivity and specificity An introduction of biochemical, non-invasive prenatal tests turned out to result in frequent false positive results of these tests in cases when invasive diagnostics does not confirm fetal defects. However prospective analysis of these cases showed numerous complications in the third trimester of the pregnancies.