İkinci trimester uterin arter Doppler bulguları ve homosistein değerlerinin kötü gebelik sonuçları öngörüsündeki yeri

Amaç: İkinci trimesterde uterin arter Doppler bulguları ve maternal serum homosistein düzeyi ile kötü gebelik sonuçları arasındaki ilişkinin araştırılması. Gereç ve yöntem: 185 gebe üzerinde yapılan prospektif olgu-kontrol çalışmasında 20-24. gebelik haftaları arasında uterin arter Doppler incelemesi yapıldı ve serum homosistein düzeyi ölçüldü.Bulgular: Gebeler uterin arter Doppler bulgularına göre bilateral erken diyastolik çentiklenmesi olanlar olgu grubu (n=97); çentik bulunmayan veya unilateral çentiklenmesi olan olgular kontrol grubu (n=88) olmak üzere iki gruba ayrıldı. Gebeliğe bağlı hipertansiyon (p

The role of second trimester uterine artery dopler findings and homocystein levels in prediction of adverse pregnancy outcome

Purpose: The aim of the study is to investigate uterine artery Doppler findings and maternal homocysteine levels in relation with adverse pregnancy outcomes during the second trimester of pregnancy. Materials and methods: A prospective case-control study was performed with 185 healthy pregnant women. Uterine artery Doppler velocimetry was performed between 20 and 24 weeks of gestation. Maternal serum homocysteine concentrations were measured. Doppler results and homocysteine levels were used in prediction of adverse pregnancy outcome.Results: According to the uterine artery Doppler findings, pregnant women were divided into two groups. The first group composed of women with bilateral diastolic notches (case group, n=85), the second group composed of the women with unilateral notches, and the women with no diastolic notch (control group, n=88) formed the third group. Pregnancy-induced hypertension (p<0.0001), small for gestational age infants (p<0.0001), and preterm delivery (p=0.02) were found to be higher in the case group in comparison with the control group 2. Although no significant differences were observed in homocysteine levels between the groups, mean pulsatility index or resistance index were significantly higher in case group compared with control group (p<0.0001). Receiver operating characteristic analysis showed that using serum homocysteine, at a 4.3 µmol/L cut off, predicted the delivery of small-for-gestational-age infants with a sensitivity of 48%, and a specificity of 76% rate [AUC (Area under the ROC Curve) =0.64; p=0.02)]. Conclusion: Presence of bilateral uterine arterial notch in second trimester was associated with adverse pregnancy outcome. Mid-trimester maternal homocysteine concentration had no role in predicting obstetric complications, but it seems to be predictive for small for gestational age infants

Kaynakça

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Harrington K, Cooper D, Lees C, Hecher K, Campbell S. Doppler ultrasound of the uterine arteries: the importance of bilateral notching in the prediction of pre- eclampsia, placental abruption or delivery of a small- for-gestational-age baby. Ultrasound Obstet Gynecol 1996;7:182-188.

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Kaynak Göster

  • ISSN: 1309-9833
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2008

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