title: Analysis of perinatal outcome by combination of first trimester maternal plasma homocysteine with uterine artery Doppler velocimetry.
abstract: OBJECTIVE
  To analyse the pregnancy outcome by combining plasma homocysteine with uterine artery Doppler velocimetry at 11 to 14 weeks of gestation.
  
  
  METHODS
  A prospective cohort study with 103 healthy pregnant women. Uterine artery Doppler velocimetry was performed at between 11 and 14 weeks of gestation. Abnormal blood flow was defined as average pulsatility index >1.5 and presence of unilateral or bilateral diastolic notch. Doppler scores were calculated by a modified scoring method of uterine artery flow velocity waveforms. Serum for measurement of homocysteine, vitamin B(12) and folate levels were collected when the ultrasonographic measurement was performed.
  
  
  RESULTS
  Pre-eclampsia developed in five, gestational hypertension in three, intrauterine growth restriction in two and preterm birth in eight patients. There was a significant difference between mean plasma homocysteine levels at different Doppler scores (p<0.001) and a weak positive correlation between Doppler scores and occurrence of pregnancy complications (r(s) = 0.232, p<0.05). Mean homocysteine level increased with increasing Doppler scores. Any uterine artery abnormality had a sensitivity of 88.9% in predicting obstetric complications. Addition of hyperhomocytenemia to Doppler scores did not change the sensitivity.
  
  
  CONCLUSIONS
  Maternal serum homocysteine level is increased in 11 to 14 weeks of gestation that is complicated with pre-eclampsia, gestational hypertension, intrauterine growth restriction and preterm birth. Addition of homocysteine determination to uterine artery Doppler in the first trimester does not add any advantage in predicting adverse perinatal outcome.
authors: Department of Obstetrics and Gynecology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
authors: Cemil
authors: C
authors: Kaymaz
authors: Ahmet
authors: A
authors: Demir
authors: Ozgur
authors: O
authors: Bige
authors: Erkan
authors: E
authors: Cagliyan
authors: Dilek
authors: D
authors: Cimrin
authors: Namik
authors: N
authors: Demir
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000000981:diagnostic imaging; D005492:Folic Acid / Q000097:blood; D005865:Gestational Age; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000000981:diagnostic imaging; D011225:Pre-Eclampsia / Q000097:blood / Q000000981:diagnostic imaging; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000000981:diagnostic imaging; D011261:Pregnancy Trimester, First / Q000097:blood; D047928:Premature Birth / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012212:Rheology; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12