Correlation between first-trimester maternal serum markers, second-trimester uterine artery doppler indices and pregnancy outcome.
OBJECTIVE
The aim of this study was to assess the correlation between first trimester maternal serum free beta-human chorionic gonadotropin (fBHCG), pregnancy-associated plasma protein A (PAPPA), second-trimester uterine artery (UA) Doppler measurements and adverse pregnancy outcomes.


METHODS
Serum levels of PAPPA and fBHCG were determined at the first trimester, and patients underwent bilateral UA Doppler assessments at 20-25 weeks of gestation. A serum PAPPA level <0.4 MoM was termed as low and the abnormal Doppler findings were the presence of bilateral notches and RI >0.52 (mean) or unilateral notch and RI >0.66 (90th percentile).


RESULTS
Mean PAPPA level was significantly lower in cases with unilateral or bilateral notches (1.09; 0.79 and 0.80 MoM for 0, 1 and 2 notches, p < 0.001). Fifty-two cases (12.8%) had a low PAPPA level; in this group the incidence of abnormal Doppler was significantly higher (34.6 vs. 18.4%, p = 0.011). In the presence of abnormal Doppler in a case with a low serum PAPPA the risk of pregnancy-induced hypertension (OR = 4.56, p = 0.0067), low birth weight (OR = 6.8, p = 0.0002) and the risk of at least one complication (OR = 7.6, p = 0.00001) were significantly high.


CONCLUSIONS
Combination of first- and second-trimester findings might improve the efficiency of screening for pregnancy complications.
Dane
Banu
B
Department of Gynecology and Obstetrics, Haseki Training and Research Hospital, Istanbul, Turkey. banudane@yahoo.com
Dane
Cem
C
Kiray
Murat
M
Cetin
Ahmet
A
Koldas
Macit
M
Erginbas
Murat
M
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011257:Pregnancy Proteins / Q000097:blood; D011261:Pregnancy Trimester, First / Q000097:blood*; D011262:Pregnancy Trimester, Second / Q000097:blood*; D047928:Premature Birth / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D055815:Young Adult
D015415:Biomarkers; D011257:Pregnancy Proteins