Kayaoğlu, Zeynep Haseki Eğitim ve Araştırma Hastanesi - Kadın Hastalıkları ve Doğum Kliniği, İstanbul , Ateş, Seda Bezmiâlem Vakıf Üniversitesi Tıp Fakültesi - Kadın Hastalıkları ve Doğum AD, İstanbul , Şumnu, Abdullah Haseki Eğitim ve Araştırma Hastanesi - Nefroloji Kliniği, İstanbul , Özel, Ayşegül Bezmiâlem Vakıf Üniversitesi Tıp Fakültesi - Kadın Hastalıkları ve Doğum AD, İstanbul , Batmaz, Gonca Haseki Eğitim ve Araştırma Hastanesi - Kadın Hastalıkları ve Doğum Kliniği, İstanbul , Dane, Banu Haseki Eğitim ve Araştırma Hastanesi - Kadın Hastalıkları ve Doğum Kliniği, İstanbul

The role of second trimester uterine artery dopler findings and homocystein levels in prediction of adverse pregnancy outcome

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Purpose: The aim of the study is to investigate uterine artery Doppler findings and maternal homocysteine levels in relation with adverse pregnancy outcomes during the second trimester of pregnancy.Materials and methods: A prospective case-control study was performed with 185 healthy pregnant women.Uterine artery Doppler velocimetry was performed between 20 and 24 weeks of gestation. Maternal serum homocysteine concentrations were measured. Doppler results and homocysteine levels were used in prediction of adverse pregnancy outcome.Results: According to the uterine artery Doppler findings, pregnant women were divided into two groups. The first group composed of women with bilateral diastolic notches (case group, n=85), the second group composed of the women with unilateral notches, and the women with no diastolic notch (control group, n=88) formed the third group. Pregnancy-induced hypertension (p 0.0001), small for gestational age infants (p 0.0001), and preterm delivery (p=0.02) were found to be higher in the case group in comparison with the control group 2.Although no significant differences were observed in homocysteine levels between the groups, mean pulsatility index or resistance index were significantly higher in case group compared with control group (p 0.0001).Receiver operating characteristic analysis showed that using serum homocysteine, at a 4.3 μmol/L cut off, predicted the delivery of small-for-gestational-age infants with a sensitivity of 48%, and a specificity of 76% rate [AUC (Area under the ROC Curve) =0.64; p=0.02)]. Conclusion: Presence of bilateral uterine arterial notch in second trimester was associated with adverse pregnancy outcome. Mid-trimester maternal homocysteine concentration had no role in predicting obstetric complications, but it seems to be predictive for small for gestational age infants.

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Uterine artery , Doppler , homocystein , pregnancy

Pamukkale Medical Journal

6

224

2015