First Trimester Screening May Prevent Pregnancy Complications

Placental vascular disorders during early pregnancy is associated with increased risk of developing serious obstetric complications, a study from The American Journal of Pathology reported.

Researchers found that patients with the highest degree of uterine artery blood flow resistance during the first trimester of pregnancy have an almost 5-fold increased risk of developing preeclampsia, fetal growth restriction, or stillbirth than other pregnant women.

A successful pregnancy requires the establishment of vascular connections between mother and embryo through placentation, which requires remodeling of the maternal uterine spiral arteries. Uterine artery Doppler (UtAD) ultrasound can measure uterine artery blood flow, and high-resistance UtAD in the first trimester is associated with increased risk of placental complications.

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Using UtAD ultrasound in ongoing pregnancies, participants were divided according to their to resistance index (RI) scores, with high-resistance defined as a mean RI >95th percentile and normal RI as <95th percentile. Researchers found that women with high RI had a 15% risk of preeclampsia and 24% risk of developing a placental complication of pregnancy (eg, preeclampsia, fetal growth restriction, or stillbirth) compared to 2.8% and 4.9% risk in women with normal RI, respectively.

The use of ultrasound scanning to find placental vascular disorders in the first-trimester may identify women at risk of developing serious obstetric complications. “If we are to institute treatments to ameliorate, or ideally prevent, the consequences of poor placentation, then an understanding of the pathophysiology in the first trimester is necessary," explained Dr. Karin Leslie of the Fetal Medicine Unit of St George's Hospital in London (UK).

For more information visit Elsevierhealth.com.

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