Second-trimester prediction of severe placental complications in women with combined elevations in alpha-fetoprotein and human chorionic gonadotrophin

American Journal of Obstetrics and Gynecology
F AlkazalehJ C P Kingdom

Abstract

The purpose of this study was to determine the ability of uterine artery Doppler and placental ultrasound to identify adverse clinical outcomes attributable to severe placental dysfunction in women with second-trimester unexplained elevated maternal serum screening of alpha-fetoprotein and human chorionic gonadotropin. Fifty singleton pregnancies with elevated alpha-fetoprotein (3.5 multiples of median [range 2.1 to 10.5]) and human chorionic gonadotropin (5.3 multiples of median [range 2.5 to 21.7]) and a normal fetal anatomical ultrasound were prospectively evaluated with placental ultrasound and uterine artery Doppler at referral between 19 and 23 weeks' gestation. Abnormalities in both placental ultrasound and uterine artery Doppler (n = 24) predicted preterm delivery less than 32 weeks from any cause (n = 24) (75% sensitivity, 75% positive predictive value; likelihood ratio positive 3.3 [1.6 to 6.8]), intrauterine fetal death (n = 12) (100% sensitivity, 50% positive predictive value; likelihood ratio positive 3.1 [2.0 to 5.0]), and intrauterine growth restriction with absent/reversed end-diastolic flow (n = 17) (sensitivity 94%, positive predictive value 67%, likelihood ratio positive 3.9 [2.0 to 6.2]) . Ischemic-thromboti...Continue Reading

Associated Clinical Trials

References

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Citations

Oct 24, 2008·Human Reproduction Update·S F de Medeiros, R J Norman
Mar 14, 2007·Current Opinion in Obstetrics & Gynecology·Aris T Papageorghiou, Karin Leslie
Aug 19, 2011·Journal of Perinatal Medicine·Ana Catarina Pedrosa, Alexandra Matias
Jul 5, 2013·International Journal of Endocrinology and Metabolism·Georgios AndroutsopoulosGeorgios Decavalas
Nov 5, 2014·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Natasha MilliganJohn C Kingdom
Aug 13, 2009·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·L K ProctorJ C P Kingdom
Jan 5, 2013·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·S PoratJ C P Kingdom
Mar 22, 2016·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Russell L DeterJohn C P Kingdom
Mar 4, 2008·American Journal of Obstetrics and Gynecology·Meghana ToalJohn C P Kingdom
Feb 20, 2009·Prenatal Diagnosis·Christine BrochetMaguy Bernard
Apr 9, 2010·Acta Clinica Belgica·Y Jacquemyn, O Zemtsova
Nov 22, 2020·Taiwanese Journal of Obstetrics & Gynecology·Li-Li LuoRui-Xue Wang
Mar 14, 2007·Current Opinion in Obstetrics & Gynecology

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