The value of Doppler assessment of the uteroplacental circulation in predicting preeclampsia or intrauterine growth retardation

Article Abstract:

A decrease in blood flow in the placenta and uterus has been reported to be associated with fetal growth retardation and preeclampsia, a condition of hypertension, or high blood pressure, edema, or water entering many body tissues, and protein in the urine. In order to determine if measurement of the uteroplacental blood flow could serve as a useful predictor of intrauterine growth retardation (IUGR) or preeclampsia, 93 women were examined at 20 or 24 weeks of pregnancy using Doppler ultrasonography. This method uses the slight change in the frequency of reflected sound waves to measure motion, including the motion of blood within arteries. The method requires not only skill on part of the operator, but some subjective judgement on which signals are good measurements and which are not. Such decisions may create a bias, making it difficult to compare results obtained by different operators. For the 93 women examined, there was a statistically significant correlation between the retardation of blood flow and IUGR. The association with preeclampsia was not statistically significant. Subsequent patient samples have essentially confirmed this result. Unfortunately, even the correlation with IUGR does not serve as a clinically useful finding. Not only did women have abnormal values without developing complications, but women with normal Doppler readings developed serious problems. In the absence of further improvements in Doppler ultrasonography, simpler and less expensive assessment methods may be used. (Consumer Summary produced by Reliance Medical Information, Inc.)

Doppler ultrasonography

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Pregnancy complications are frequent in long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency

Article Abstract:

Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase (LCHAD) deficiency in fetuses substantially increases the risk of preeclampsia in the mother and growth restriction in the fetus. LCHAD deficiency is a disorder of fatty acid oxidation in cellular mitochondria. Researchers evaluated all pregnancies of 18 women who gave birth to 28 children with LCHAD deficiency and 35 healthy children. Thirty percent of pregnancies with LCHAD-deficient fetuses were complicated by preeclampsia, but no healthy pregnancies were so affected. Almost half of fetuses with the defect were growth-restricted.

Fatty acid metabolism, Metabolism, Inborn errors of, Inborn errors of metabolism, Fatty acid desaturases

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The paradoxical effect of smoking in preeclamptic pregnancies: smoking reduces the incidence but increases the rates of perinatal mortality, abruptio placentae, and intrauterine restriction

Article Abstract:

While smoking may reduce the risk for preeclampsia in pregnant women it appears to substantially increase the risk for other birth complications. The health records of 317,652 deliveries to first-time mothers aged 15 to 34 years were studied. Mothers who smoked were half as likely to have severe preeclampsia than nonsmokers. However, infants of women who smoked 10 or more cigarettes a day were more likely to die at or around the time of birth or to be born small for their age. Smoking mothers were also at increased risk for having a detached placenta.

Patient outcomes, Mortality, Pregnant women, Smokers, Infants (Newborn), Newborn infants, Smoking, Infant mortality, Abruptio placentae, Placental abruption

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