Doppler velocimetry and thrombophilic screening at middle trimester of gestation: preliminary data

• Published in: European journal of obstetrics & gynecology and reproductive biology 2001-11, Vol.99 (1), p.38-46
• Main Authors: Delle Chiaie, L., Gramellini, D., Piantelli, G., Manotti, C., Fieni, S., Vadora, E.
• Format: Article
• Language: English
• Subjects: Adult; Arteries - diagnostic imaging; Arteries - physiology; Biological and medical sciences; Blood Flow Velocity; Coagulation parameter; Diseases of mother, fetus and pregnancy; Doppler velocimetry; Female; Fetal Growth Retardation - diagnostic imaging; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Pre-Eclampsia - diagnostic imaging; Predictive Value of Tests; Pregnancy; Pregnancy Complications, Hematologic - diagnostic imaging; Pregnancy Outcome; Pregnancy Trimester, Second; Pregnancy. Fetus. Placenta; Prospective Studies; Reference Values; Thrombophilia; Thrombophilia - complications; Thrombophilia - diagnostic imaging; Ultrasonography, Doppler - methods; Ultrasound; Uterus - blood supply; Uterus - diagnostic imaging
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/S0301-2115(01)00352-9

Objective: To establish whether asymptomatic normotensive pregnant women with an abnormal uterine Doppler velocimetry, have haematological changes characteristic of congenital or acquired thrombophilia, and whether this information improve predict in pregnancy complications. Study design: A prospective study involved the enrolment of 30 healthy normotensive pregnant women between the 23rd and 27th week of gestation, subdivided into group A (normal uterine Doppler velocimetry) and group B (abnormal uterine Doppler velocimetry). Besides uterine velocimetry (resistence index and presence/absence of notch), at enrolment in the study the PI of the umbilical artery and of the middle cerebral artery were measured, in addition to the usual foetal biometric parameters (biparietal diameter and abdominal circumference). Contemporaneously, a 20 ml blood sample was taken for the dosage of protein C, protein S, antithrombin III, activated protein C resistance, antiphospholipid antibodies and platelet functionality. Subsequently, for all the remaining period of the pregnancy, data were collected relating to the onset of any materno-foetal complications and modality of delivery, as well as neonatal data up to the first 20 days of life. Results: The incidence of adverse perinatal outcomes (pre-eclampsia, gestational hypertension, abruptio placentae, endouterine foetal death, preterm birth, caesarean section because of maternal or foetal problems, APGAR score lower than 7 at the 5th minute of life, small for gestational age) resulted as being 75% in group B versus 11% in group A ( P