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De‐novo abnormal uteroplacental circulation in third trimester: pregnancy outcome and pathological implications

Binder, J; Monaghan, C; Thilaganathan, B; Carta, S; Khalil, A (2018) De‐novo abnormal uteroplacental circulation in third trimester: pregnancy outcome and pathological implications. Ultrasound Obstet Gynecol, 52 (1). pp. 60-65. ISSN 1469-0705 https://doi.org/10.1002/uog.17564
SGUL Authors: Khalil, Asma

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Abstract

Objective Hypertensive disorders of pregnancy (HDP) are associated with impaired placentation, as evidenced by abnormal uterine artery (UtA) Doppler. In normal pregnancy, mean UtA pulsatility index (PI) shows a progressive decline with gestational age (GA). However, previous studies have reported that a proportion of pregnancies demonstrate worsening UtA Doppler in later pregnancy. The aim of this study was to investigate the incidence of HDP according to the change in mean UtA‐PI between the second and third trimesters. Methods This was a retrospective cohort study of singleton pregnancies between March 1997 and March 2016 that underwent longitudinal UtA Doppler assessment in the second and third trimesters. All parameters were converted into centiles or multiples of the median (MoM), adjusting for GA. The study cohort was divided into two groups, according to change in mean UtA‐PI between the second and third trimesters (those with a decrease or no change and those with an increase). HDP included women who developed pre‐eclampsia and/or gestational hypertension. Logistic regression analysis was used to adjust for potential confounders. Results The analysis included 5887 pregnancies. The incidence of HDP was significantly higher in the group with increasing mean UtA‐PI compared with those without (7.9% vs 5.8%; P = 0.002). Logistic regression analysis demonstrated that both third‐trimester UtA‐PI MoM (odds ratio (OR), 7.35; 95% CI, 4.66–11.6; P < 0.001) and stable or decrease in UtA‐PI MoM between the second and third trimesters (OR, 0.43; 95% CI, 0.31–0.60; P < 0.001) were significant independent predictors for the development of HDP. Conclusion Worsening of UtA Doppler is associated with HDP, independent of the value recorded in the second trimester.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Binder, J. , Monaghan, C. , Thilaganathan, B. , Carta, S. and Khalil, A. (2018), De‐novo abnormal uteroplacental circulation in third trimester: pregnancy outcome and pathological implications. Ultrasound Obstet Gynecol, 52: 60-65, which has been published in final form at http://doi.org/10.1002/uog.17564. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: Uterine artery Doppler, de- novo abnormal uterine artery Doppler, uteroplacental circulation, pregnancy hypertension, uterine artery Doppler worsening, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Ultrasound Obstet Gynecol
ISSN: 1469-0705
Language: eng
Dates:
DateEvent
4 July 2018Published
11 June 2018Published Online
22 June 2017Published Online
13 June 2017Accepted
Publisher License: Publisher's own licence
PubMed ID: 28640514
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108926
Publisher's version: https://doi.org/10.1002/uog.17564

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