Department of Obstetrics and Gynecology, LHMC, New Delhi, India.
Department of Obstetrics and Gynecology, LHMC, New Delhi, India.
Placenta. 2024 Sep 2;154:153-159. doi: 10.1016/j.placenta.2024.07.003. Epub 2024 Jul 4.
To assess the placental biometry, placental biomarkers and uterine artery Doppler in each trimester of pregnancy for prediction of early-onset fetal growth restriction (EO FGR).
In this prospective cohort study placental biometry; biomarkers PAPP-A, sFLT-1, and PlGF along with the uterine artery blood flow evaluation was done serially at 11-14, 20-24 and 28-32 weeks of gestation. The above parameters were compared between women with early onset FGR and controls.
Out of 1008 fully followed cases, the small for gestational age fetuses were 227/1008 (22.5 %), and EO FGR were 84/1008(8.3 %).The placental length, volume, and PlGF levels were significantly lower, whereas the uterine artery PI(Ut PI) was significantly higher at all time points among cases. The sFLT-1 level showed a significant increase among cases, whereas it decreased among controls from the first to the second trimester. The detection rate using PV/UtA PI was 60 % in the first trimester and 66.7 % in the second trimester at 30 % FPR.
The PV/Ut PI in first and the second trimester was a good marker for the prediction of pregnancies at increased risk of developing EO FGR.
评估妊娠各期胎盘生物计量学、胎盘生物标志物和子宫动脉多普勒血流，以预测早发型胎儿生长受限（EO FGR）。
在这项前瞻性队列研究中，在 11-14、20-24 和 28-32 孕周连续进行胎盘生物计量学、PAPP-A、sFLT-1 和 PlGF 等生物标志物以及子宫动脉血流评估。将上述参数与早发型 FGR 患者和对照组进行比较。
在 1008 例完全随访的病例中，小于胎龄儿为 227/1008（22.5%），EO FGR 为 84/1008（8.3%）。病例组的胎盘长度、体积和 PlGF 水平明显较低，而所有时间点的子宫动脉 PI（Ut PI）均明显较高。sFLT-1 水平在病例组中呈显著升高，而对照组则从第一到第二孕期逐渐降低。使用 PV/UtA PI 的检出率在第一孕期为 60%，在第二孕期为 30% FPR 时为 66.7%。
第一和第二孕期的 PV/Ut PI 是预测发生 EO FGR 风险增加的妊娠的良好标志物。
