Ductus venosus doppler s/d value adjusted alfa fetoprotein levels to decrease false positive rates

AMAÇ: Fetal karaciğer çoğunlukla duktus venozus aracılığıy- la umbilikal venden beslenmektedir. Alfa Fetoprotein (AFP) fe- tal karaciğerde üretilip, salgılanmaktadır. Çalışmamızda, se- rum AFP düzeyine duktus venozus ve umbilikal kan akımının etkisi incelendi. GEREÇ VE YÖNTEM: Çalışmaya 16-20 hafta gebeliği olan 60 kadın alındı. Olgular AFP seviyeleri 2 MoM üzeri (n=46) ve al- tı (n=14) olarak ikiye ayrıldı. Tüm olgular serum AFP ölçümü ile Doppler görüntülemede duktus venozus ve umbilikal arter S/D oranı değerlendirmesine yönlendirildi. Duktus venozus ve umbilikal arter kan akımının serum AFP seviyesi üzerine olan etkisi araştırıldı. BULGULAR: Umbilikal arter ve duktus venozus kan akımının serum AFP seviyesi ile ilişkili olduğu saptandı (p

Duktus venozus s/d oranına göre düzeltilmiş alfa fetoprotein düzeyinin yalancı pozitiflik oranını azaltması

OBJECTIVE: Fetal liver is mostly perfused by umbilical vein via ductus venosus and AFP is synthesized and secreted from fetal liver. In this study we tried to determine the effect of ductus venosus and umbil- ical blood flow on serum AFP levels STUDY DESIGN: Sixty women with 16-20 weeks of gestation were enrolled for the study. Subjects were divided into two: AFP levels lower (n=46) and higher than 2 MomS MoMs (n=14). All participants un- derwent serum AFP, ductus venosus and umbilical artery Doppler Doppler S/D screening. Effect of duc- tus venosus and umbilical artery blood flow on serum AFP levels were analyzed. RESULTS: Ductus venosus (AUC=0.945, P<0.001) and umbilical artery Doppler S/D (AUC=0.803, P=0.001) values were predictor for low AFP levels. In regression analysis, Ductus venosus Doppler S/D (Beta coefficient= -0.442, P<0.001) and umbilical artery S/D (Beta coefficient= -0.291, P=0.011) values were significantly associated with the AFP levels (R2=0.60). DV and umbilical artery Doppler S/D values adjusted serum AFP levels remained significant but mean value of AFP in group with AFP>2 MoM be- came 1.98 MoM after adjustment. CONCLUSION: Our study revealed that Ductus venosus and umbilical artery S/D value adjusted serum AFP levels may have lower false positive rates.

Kaynakça

1. Hecher K, Campbell S, Doyle P, Harrington K, Nicolaides K. Assessment of fetal compromise by Doppler ultrasound investigation of the fetal circulation. Arterial, intracardiac, and venous blood flow velocity studies. Circulation 1995; 91(1):129-38

2. Gilani SA, Javaid A, Bala AA. Fetal Doppler ultrasound assessment of ductus venosus in a 31-40 [corrected] weeks gestation normal fetus in the Pakistani population. Med Ultrason 2010;12(2):110-3.

3. Tchirikov M, Schröder HJ, Hecher K. Ductus venosus shunting in the fetal venous circulation: regulatory mech- anisms, diagnostic methods and medical importance. Ultrasound Obstet Gynecol 2006;27(4):452-61.

4. Eger SH, Sommerfelt K, Kiserud T, Markestad T. Foetal umbilical artery Doppler in small preterms: (IQ) Neurocognitive outcome at 5 years of age. Acta Paediatr 2013;102(4):403-9

5. Schwarze A, Gembruch U, Krapp M, Katalinic A, Germer U, Axt-Fliedner R. Qualitative venous Doppler flow waveform analysis in preterm intrauterine growth-re- stricted fetuses with ARED flow in the umbilical artery- correlation with short-term outcome. Ultrasound Obstet Gynecol 2005;25(6):573-9.

6. Demirturk F, Caliskan AC, Aytan H, Sahin S. A prelimi- nary retrospective study about the relationship between ductus venosus Doppler indices, nuchal translucency (NT) and biochemical markers in the first and second trimester screening tests. Gynecol Endocrinol 2012;28(5):378-81.

7. Greene ND, Stanier P, Moore GE. The emerging role of epigenetic mechanisms in the etiology of neural tube de- fects. Epigenetics 2011;6:875-83.

8. Volcik KA, Blanton SH, Kruzel MC et al. Testing for ge- netic associations in a spina bifida population: Analysis of the HOX gene family and human candidate gene regions implicated by mouse models of neural tube defects. Am J Med Genet 2002;110:203-207.

9. Driscoll DA, Gross SJ, Proffesional Practice Guidelines Committee. Screening for fetal aneuploidi and neural tube defect. Genet Med 2009;11:818

10. Zapol WM, Liggins GC, Schneider RC, Qvist J, Snider M, et al. Regional blood flow during simulated diving in the conscious Weddell seal. J Appl Physiol 1979;47:968-73.

11. Wladimiroff JW, Van Der Wijngaard JAGW, Degani S, Noordam MJW, Van Eyck J, et al. Cerebral and umbilical arterial blood flow velocity waveforms in normal and growth-retarded pregnancies. Obstet Gynecol 1987; 69:705-9.

12. Maiz N, Valencia C, Kagan KO, Wright D, Nicolaides KH. Ductus venosus Doppler in screening for trisomies 21, 18 and 13 and Turner syndrome at 11-13 weeks of ges- tation. Ultrasound Obstet Gynecol 2009;33:512-7.

13. Cunningham FG, Leveno KJ, Bloom SL, Houth JC, Rouse DJ, Spong CY. Prenatal Diagnosis and Therapy. In Cunningham FG, Leveno KJ, Bloom SL, Houth JC, Rouse DJ, Spong CY, editors. Williams Obstetrics. 23rd ed. 2010. pp 289.

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