1,721,039 research outputs found
Gestosi '99 : 9. Congresso Organizzazione Italiana Gestosi e Ipertensione in Gravidanza (O.I.G.C.)
No full text
Late normalisation of uterine artery velocimetry in high risk pregnancy
No full textOBJECTIVE:
To test whether late normalisation of abnormal uterine velocimetry is a favourable prognostic factor in high risk pregnancies.
STUDY DESIGN:
Uterine artery colour Doppler velocimetry was performed at 24, 28-30 and 32-34 weeks in 282 high risk pregnancies treated with low dose aspirin.
RESULTS:
88 patients had abnormal waveforms at 24 weeks and 77 delivered after the second assessment at 28 weeks. Of these, 38 (49%) had a normalisation of Doppler indices by 34 weeks. Compared with the persistently abnormal Doppler group, these patients delivered fewer small for gestational age babies (5/38 versus 26/39; p=0.0001) and had less gestational hypertension without proteinuria (3/38 versus 15/39; p=0.004). No patients with preeclampsia or other severe complications of pregnancy were observed in the normalised group.
CONCLUSIONS:
Although abnormal uterine artery velocimetry at 24 weeks is predictive of adverse pregnancy outcome, nearly half have late normalisation of the Doppler indices and a better perinatal outcome. Persistently abnormal waveforms are related to the worst pregnancy outcome
Doppler velocimetry of the uterine arteries in nulliparous women.
No full textThe aim of this study was to evaluate the role of uterine artery Doppler velocimetry performed at 20 and 24 weeks gestation in predicting gestational hypertension and small-for-gestational age babies in a population of nulliparous women. Four hundred and fifty-six patients without risk factors for pregnancy complications and with fetuses free from structural abnormalities at ultrasonographic examination at 20 weeks gestation were considered in the study. During the routine 20 weeks ultrasound a continuous-wave Doppler examination of the uterine arteries was performed. The patients with abnormal uterine Resistance Index (RI) repeated the Doppler evaluation at 24 weeks by means of Colour Doppler equipment. Among the 419 women who completed the study an abnormal Doppler uterine arteries velocimetry was found in 8.6% of the patients. Pregnancy complications (gestational hypertension and/or small-for-gestational age babies) were observed in 56% of the patients presenting high uteroplacental RI versus 10% of those with normal uterine artery velocimetry (P = 0.0001). In the group of patients with an abnormal RI value, the presence of a diastolic notch in one or both of the uterine arteries identified a population of pregnant women at higher risk for pregnancy complications when compared with patients without notch (78% vs. 33%, P = 0.007). The knowledge of the uteroplacental resistance can help in identifying a subgroup of patients at higher risk of hypertensive disorders and small-for-gestational age babies that could benefit from prophylaxis with low dose aspirin
Low dose aspirin in pregnancy: a clinical and biochemical study of effects on the newborn
No full textClinical followup and screening for autoimmune disorders in patients with previous severe early onset preeclampsia
No full textEndothelial dysfunction and vascular stiffness in women with a previous pregnancy complicated by early or late preeclampsia.
Full text linkOBJECTIVES:
Pre-eclampsia leads to an increased cardiovascular risk later in life. The persistence of endothelial dysfunction after delivery may represent the link between pre-eclampsia and cardiovascular disease. We aimed at evaluating endothelial function and arterial stiffness after pregnancies complicated by early-onset or late-onset pre-eclampsia and their correlation with gestational age and mean uterine artery pulsatility index both considered at the diagnosis of pre-eclampsia and birth weight percentile.
METHODS:
30 women who experienced early-onset pre-eclampsia, 30 with a previous late-onset pre-eclampsia and 30 controls were recalled from 6 months to 4 years after delivery. All women included were free from cardiovascular risk factors and drugs. We studied them by peripheral arterial tonometry and pulse wave analysis.
RESULTS:
All vascular parameters were all significantly impaired in early-onset pre-eclampsia. Late-onset pre-eclampsia showed higher vascular rigidity than controls' and normal values of reactive hyperaemia index, although it was significantly lower in respect with controls'. On the multivariate analysis gestational age and mean uterine artery pulsatility index, both considered at the diagnosis of the disease, and birth weight percentile were statistically related to the vascular indexes we studied, after correcting for confounding parameters.
CONCLUSIONS:
Women with previous pregnancies complicated by pre-eclampsia, in particular cases with early-onset of the disease, showed a persistent microcirculatory dysfunction, as suggested by a significant reduction of reactive hyperaemia index value, and an increased arterial stiffness
Elastic properties of ascending aorta in patients with a previous pregnancy complicated by early or late preeclampsia
No full textOBJECTIVES:
To evaluate the elastic properties of the ascending aorta in women with a previous pregnancy complicated by early-onset (EO) or late-onset (LO) pre-eclampsia (PE) and the correlation with gestational age (GA), systolic/diastolic blood pressure (SBP/DBP) and mean uterine artery pulsatility index (UtA-PI) at diagnosis of the disease as well as with birth weight of the neonate.
METHODS:
Thirty women who had a previous pregnancy complicated by EO-PE, 30 with a previous pregnancy complicated by LO-PE and 30 normal controls were selected retrospectively from our electronic database and then recalled for assessment from 6 months to 4 years after delivery. Data regarding GA, SBP/DBP and mean UtA-PI at the diagnosis of PE were obtained from medical records. At our assessment, aortic M-mode and tissue Doppler imaging (TDI) parameters were measured. Aortic diameters were assessed at end-diastole at four levels: Valsalva sinuses, sinotubular junction, tubular tract and aortic arch. Aortic compliance, distensibility, stiffness index (SI), Peterson's elastic modulus (EM), pulse-wave velocity and M-mode strain were calculated using standard formulae. Aortic expansion velocity, early and late diastolic retraction velocities and peak systolic tissue strain (TDI-ε) were determined.
RESULTS:
Aortic diameters at the four levels were significantly greater in both EO-PE and LO-PE groups than in controls. Aortic compliance and distensibility and TDI-ε were lower in EO-PE than in LO-PE (P = 0.001, P = 0.002 and P = 0.011, respectively) and controls (P = 0.037, P = 0.044 and P = 0.013, respectively). SI and EM were higher in EO-PE than in LO-PE (P = 0.001 and P < 0.001, respectively) and than in controls (P = 0.035 and P = 0.036, respectively). Multivariate analysis showed GA, DBP and UtA-PI at diagnosis of PE to be independent predictors of aortic elastic properties.
CONCLUSIONS:
Elastic properties of the ascending aorta were altered in women with a previous pregnancy complicated by EO-PE, but not in those with LO-PE
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