Projects / Programmes
BIOCHEMICAL AND ULTRASOUND MARKERS FOR PREGNANCY COMPLICATIONS II.
| Code |
Science |
Field |
Subfield |
| 3.05.00 |
Medical sciences |
Human reproduction |
|
| Code |
Science |
Field |
| B570 |
Biomedical sciences |
Obstetrics, gynaecology, andrology, reproduction, sexuality |
Pregnancy complications, preeclampsia, preterm labour, intrauterine growth restriction, intrauterina fetal death, screening tests, free βhCG, PAPP-A, PP-13, VEGF, PlGF, sFlt-1, Doppler ultrasound examination of uterine arteries
Researchers (16)
Organisations (1)
Abstract
In the developed world the diseases that occur due to abnormal placental implantation are the leading cause of maternal and fetal morbidity and mortality. These diseases include hypertension in pregnancy, intrauterine growth restriction, very preterm labour (before the 32nd gestational week) and miscarriage after the 10th gestational week.. Current established clinical methods permit the diagnosis of these complications when they are already fully developed. This leaves no possibility for their efficient prevention; we can but prevent or appease their consequences for maternal and fetal health. At routine use of markers for detecting fetal congenital malformations a connection between changed values of biochemical markers and complications in pregnancy, related to placental dysfunction was observed. Observation of blood flow through uterine arteries using Doppler ultrasound examination permits monitoring of the problems due to adaptation of maternal vasculature to pregnancy.
In the study we will enrol mothers coming for a screening test for chromosomopathies between 11th and 14th gestational week. In addition to nuchal translucency measurement and fetal biometry, Doppler ultrasound examination of uterine arteries will be made, and a blood sample taken for the determination of free βhCG, PAPP-A, PP-13, VEGF, PlGF and sFlt-1 concentrations - they will be compared to medians calculated for gestational age. Fetal biometry and Doppler ultrasound examination will be repeated betwen the 22nd and 24th and between the 30th and 32nd gestational week. Maternal data will include age, date of last menstruation, body weight and height, smoking status, number of previous pregnancies and deliveries. After termination of pregnancy the data on pregnancy complications (hypertensive complications, diabetes mellitus in pregnancy, stillbirth, spontaneous abortion, induced abortion for fetal anomalies) gestational age at delivery (very preterm delivery before the 32nd week, preterm delivery before the 37th week, delivery after the 37th week), type of delivery, and birthweight (small for gestational age, appropriate for gestational age, large for gestational week) will be retrospectively collected.
Comparison of the values of certain biochemical and ultrasound markers in the first trimester and complications later in pregnancy will permit find the markers that are potentially useful in the early detection of mothers at risk for pregnancy complications, and possibly a combination of markers that might have a better performance than a single marker.
Significance for science
The findings of this research project will contribute to the understanding of the events in early pregnancy. We have found that with some complications jeopardizing the life and health of the mother and the newborn, the values of biochemical markers and the ratios between them are changed already in the first trimester of pregnancy. Increased VEGFR-1:PlGF ratio predicts the delivery of an SGA baby and preterm delivery before the 32nd week of pregnancy. Decreased P1GF concentrations at 11-14 weeks of gestation are associated with hypertensive disorders and a delivery of an SGA baby. VEGFR-1 has not been found an efficient marker for early screening of complications in pregnancy.
Significance for the country
Maternal and neonatal morbidity and mortality are important indicators of the degree of health care in the country, their decrease contributes to the country’s affirmation. Based on the obtained results, the researchers involved in carrying the research project out, have joined the international scientific community, have contributed to the increased understanding of the events in early pregnancy and to the preparation of screening tests that will change the management of pregnancy in the future.
The results of this research project increase the knowledge and awareness of the impact of screening tests for chromosomopathies and for severe complications in pregnancy, the intention being to reduce maternal and neonatal morbidity and mortality.
Intense education of both pregnant women and their gynecologists about screening and diagnostic tests for chromosomopathies has resulted in substantial decrease in the number of newborns with chromosomopathies, which is important not only for the mother but also for the entire society.
Most important scientific results
Annual report
2008,
2009,
final report,
complete report on dLib.si
Most important socioeconomically and culturally relevant results
Annual report
2008,
2009,
final report,
complete report on dLib.si
