Emergence of Late-Onset Placental Dysfunction: Relationship to the Change in Uterine Artery Blood Flow Resistance between the First and Third Trimesters

作者：Llurba Elisa; Turan Ozhan; Kasdaglis Tania; Harman Chris R; Baschat Ahmet A^*

来源：American Journal of Perinatology, 2013, 30(6): 505-511.

DOI：10.1055/s-0032-1329181

• constitutionally small neonates
• fetal growth restriction
• preeclampsia
• uterine artery Doppler
• third trimester

Objectives To test if emergence of third-trimester (T3) placental dysfunction is related to the impedance change in uterine artery blood flow resistance between the first trimester (T1) and T3. %26lt;br%26gt;Study Design Mean T1 and T3 uterine artery (mUtA) pulsatility index (PI) was measured in 1098 singletons. Each patient%26apos;s individual mUtA-PI change was calculated ([(T3 PI - T1 PI/interval in days)] x 100; Delta mUtA-PI). This parameter and T1 and T3 mUtA-PI z-scores were related to placenta-related disease (PRD) and to constitutionally small neonates (CS). %26lt;br%26gt;Results Forty-seven (5%) women had PRD and 83 (8.7%) delivered a CS neonate. T1 and T3 mUtA-PI z-scores were higher with PRD (0.418 versus -0.097 and 1.06 versus -0.13, p %26lt; 0.001 for all). Change in mUtA-PI (Delta mUtA PI) was similar for patients with PRD. However, the prevalence of PRD doubled with rising Delta mUtA-PI (11.1% versus 5.2%, p = 0.041). %26lt;br%26gt;Conclusion T3 uterine artery Doppler performs significantly better in detecting patients at risk for late-onset PRD than T1 or the gestational age change in uterine artery Doppler resistance This suggests that a proportion of late emerging PRD is not amenable to early screening by uterine artery Doppler. Further research is essential to identify the optimal screening strategy for late-onset placental dysfunction.

• 出版日期2013-6