Using Doppler ultrasound of the uterine and umbilical arteries and disordered angiogenesis markers (sFlt-1/PlGF) in unified monitoring of ischemic placental syndrome patients.
OBJECTIVE
The shared pathogenesis of placental ischemia entitles us to create a single treatment model. We attempted to develop a unified method for monitoring ischemic placental syndrome patients using Doppler ultrasound of the uterine and umbilical arteries and disordered angiogenesis markers sFlt-1 and PlGF.


METHODS
182 pregnant women suffering from the ischemic placental syndrome were divided into four groups depending on the severity of their lesions revealed in the Doppler ultrasound examination and weeks of pregnancy. We analyzed the behavior of clinical and biochemical parameters in these groups and the correlations between the ultrasound examination and the disordered angiogenesis markers.


RESULTS
In the group of patients demonstrating more severe Doppler ultrasound lesions, the clinical and biochemical parameters were significantly more expressed, whereas unfavorable obstetric events occurred either earlier or more frequently. Lesions revealed in Doppler occur more commonly in groups before 34th week of pregnancy. Disordered angiogenesis markers are significantly correlated with ultrasound examination results.


CONCLUSIONS
A unified method for monitoring the ischemic placental syndrome based on pathogenetic, biophysical (Doppler ultrasound), and biochemical (sFlt-1/PlGF) parameters is feasible and constitutes a valuable supplement to the existing standards, while the high correlations between Doppler ultrasound examinations and both sFlt-1 and PlGF point to a shared pathogenesis of the lesions. Intensity of Doppler changes is connected with time of testing and pregnancy duration.
a Department of Gynecology and Obstetrics , Pomeranian Medical University , Szczecin , Poland.
Sebastian
S
Kwiatkowski
b Department of Nephrology , Transplantology and Internal Medicine, Pomeranian Medical University , Szczecin , Poland.
Ewa
E
Kwiatkowska
a Department of Gynecology and Obstetrics , Pomeranian Medical University , Szczecin , Poland.
Rafał
R
Rzepka
c Department of Laboratory Diagnostics , Pomeranian Medical University , Szczecin , Poland.
Barbara
B
Dołegowska
a Department of Gynecology and Obstetrics , Pomeranian Medical University , Szczecin , Poland.
Andrzej
A
Torbe
a Department of Gynecology and Obstetrics , Pomeranian Medical University , Szczecin , Poland.
Agata
A
Bartosik-Sławińska
D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D010920:Placenta / Q000098:blood supply / Q000000981:diagnostic imaging*; D000072483:Placenta Growth Factor / Q000097:blood*; D010927:Placental Insufficiency / Q000097:blood* / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011446:Prospective Studies; D018608:Ultrasonography, Doppler; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D055815:Young Adult
D015415:Biomarkers; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1
Doppler ultrasound; Ischemic placental syndrome; PlGF; angiogenesis; sFlt-1