Second- and third-trimester biochemical and ultrasound markers predictive of ischemic placental disease.
Ischemic placental disease is a recently coined term that describes the vascular insufficiency now believed to be an important etiologic factor in preeclampsia, intrauterine fetal growth restriction, and placental abruption. Given the increased risk for poor maternal and fetal outcomes, early prediction and prevention of this disorder is of significant clinical interest for many. In this article, we review the second- and third-trimester serum and ultrasound markers predictive of ischemic placental disease. Limited first-trimester data is also presented. While current studies report a statistical association between marker levels and various adverse perinatal outcomes, the observed diagnostic accuracy is below the threshold required for clinical utility. An exception to this generalization is uterine artery Doppler for the prediction of early-onset preeclampsia. Metabolomics is a relatively new analytic platform that holds promise as a first-trimester marker for the prediction of both early- and late-onset preeclampsia.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Rochester, MI.
Zeynep Alpay
ZA
Savasan
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Rochester, MI.
Luis F
LF
Goncalves
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Rochester, MI. Electronic address: Ray.Bahado-Singh@Beaumont.edu.
Ray O
RO
Bahado-Singh
D000037:Abruptio Placentae / Q000175:diagnosis* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000175:diagnosis*; D010920:Placenta / Q000098:blood supply*; D010922:Placenta Diseases / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D021041:Placental Circulation; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000209:etiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000209:etiology; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012039:Regional Blood Flow; D018615:Ultrasonography, Doppler, Color
D015415:Biomarkers