Sağlık Bilimleri Üniversitesi Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
Sağlık Bilimleri Üniversitesi Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2021 Jul;262:57-61. doi: 10.1016/j.ejogrb.2021.05.008. Epub 2021 May 7.
To evaluate the outcomes, and predictive value of uterine artery pulsatility index (UtA-PI) and second-trimester maternal serum alpha-fetoprotein (MSAFP) for adverse obstetric outcomes in cases with morphologically confirmed circumvallate placenta by comparison with normal pregnancies.
This prospective study was conducted in a tertiary referral hospital between January 2017 and December 2019. During the study period, 77 patients with a circumvallate placenta and 77 patients without any placental or feto-maternal diseases or abnormalities were evaluated. The final diagnosis was made based on macroscopic examination of the placenta soon after birth. Demographic characteristics, MSAFP, obstetric complications, haemoglobin after delivery, gestational week of birth, fetal sex, 1- and 5-min Apgar scores, postnatal complications and type of delivery were retrieved from hospital records. Bilateral mean transabdominal UtA-PI and MSAFP were evaluated for the prediction of adverse outcomes. SPSS Version 21.0 for Windows was used for statistical analysis, and receiver operating characteristic (ROC) curves were used for the prediction model of adverse outcomes.
Smoking rate, MSAFP, preterm birth and intrauterine growth restriction (IUGR) were higher in the patients with a circumvallate placenta (p = 0.005, 0.00, 0.025 and 0.027, respectively). The cut-off value of MSAFP was 1.41 (0.60-3.32) and the cut-off value of UtA-PI was 1.2 using the ROC curves, and had sensitivity of 73.7 % and specificity of 71.9 %, and sensitivity of 73.7 % and specificity of 76.3 %, respectively (p < 0.05).
Circumvallate placenta was associated with a higher rate of IUGR, preterm birth and bleeding at the time of delivery. In patients with a circumvallate placenta, UtA-PI and MSAFP may be valuable as predictors of IUGR.
通过与正常妊娠相比，评估形态学上确诊的帆状胎盘患者的子宫动脉搏动指数（UtA-PI）和中期母体血清甲胎蛋白（MSAFP）与不良产科结局的相关性及其预测价值。
这是一项在 2017 年 1 月至 2019 年 12 月期间在三级转诊医院进行的前瞻性研究。在研究期间，评估了 77 例帆状胎盘患者和 77 例无任何胎盘或胎儿-母体疾病或异常的患者。最终诊断基于产后立即对胎盘进行的宏观检查。从医院记录中获取人口统计学特征、MSAFP、产科并发症、产后血红蛋白、分娩孕周、胎儿性别、1 分钟和 5 分钟 Apgar 评分、产后并发症和分娩方式。评估双侧平均经腹 UtA-PI 和 MSAFP 以预测不良结局。使用 Windows 版 SPSS 版本 21.0 进行统计分析，并使用受试者工作特征（ROC）曲线对不良结局的预测模型进行分析。
帆状胎盘患者的吸烟率、MSAFP、早产和宫内生长受限（IUGR）发生率较高（p = 0.005、0.00、0.025 和 0.027）。使用 ROC 曲线，MSAFP 的截断值为 1.41（0.60-3.32），UtA-PI 的截断值为 1.2，其敏感性分别为 73.7%和特异性为 71.9%，敏感性为 73.7%和特异性为 76.3%（p<0.05）。
帆状胎盘与 IUGR、早产和分娩时出血的发生率较高相关。在帆状胎盘患者中，UtA-PI 和 MSAFP 可能是 IUGR 的有价值的预测指标。
