Perinatal outcome prediction by maternal homocysteine and uterine artery Doppler velocimetry.
OBJECTIVE
(a) To evaluate the predictive value of uterine Doppler velocimetry for pregnancy complications, (b) to study the relationship between abnormal uterine Doppler velocimetry and plasma homocysteine, and (c) to determine whether homocysteine measurement improves the predictive value of uterine Doppler screening.


METHODS
Prospective study including 94 pregnant women without previous risk factors. Total homocysteine, folate and Vitamin B(12) were analysed. Uterine Doppler velocimetry at weeks 24-25 was performed.


RESULTS
The presence of any uterine Doppler alteration had a sensitivity of 66.7%, and a specificity of 81.2%, in predicting obstetric complications. The likelihood ratio was 3.6. The positive and negative predictive values were 27.3 and 95.8%, respectively. The global efficiency was 83.0%. The addition of hyperhomocysteinemia to Doppler alterations increased the sensitivity from 66.7 to 77.8%.


CONCLUSIONS
The addition of homocysteine determination to uterine Doppler evaluation in the second trimester does not usefully improve its predictive value.
López-Quesada
Eva
E
Obstetrics and Gynecology Department, Hospital Sant Joan de Déu, University of Barcelona, Esplugues de Llobregat, Passeig Sant Joan de Déu 2, Barcelona 08950, Spain.
Vilaseca
M Antonia
MA
Vela
Antonio
A
Lailla
Josep M
JM
D000328:Adult; D001158:Arteries / Q000502:physiology; D001783:Blood Flow Velocity; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply*; D014805:Vitamin B 12 / Q000097:blood
D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12