Skip to main content

The value of uterine artery Doppler and NT-proBNP levels in the second trimester to predict preeclampsia

Archives of Gynecology and Obstetrics volume 291, pages 1253–1258 (2015)Cite this article

Abstract

Objective

To determine the maternal serum N-Terminal proBNP levels in predicting development of preeclampsia.

Method

Sixty-eight patients were included in the study. The study group consisted of patients with the finding of diastolic notch with abnormal pulsatility index (PI) between 21–24 weeks gestation and the control group consisted of patients without diastolic notch and normal PI. The study included high-risk patients who did not have a history of hypertensive disorder before pregnancy, heart failure, recurrent pregnancy loss, autoimmune disorder or diabetes. The groups were compared in terms of NT-ProBNP levels, development of preeclampsia, obstetric and neonatal problems.

Results

There was no significant difference between groups in terms of age, gravidity, parity, uric acid levels, and NT-proBNP levels. There was significant difference between the groups in terms of week of birth, rate of cesarean section and fetal weight. Furthermore, there were significant differences between the two groups when compared in terms of obstetric and neonatal problems (p < 0.05). Obstetric and neonatal problems were more common in the notch with abnormal (PI) group. The NT-pro BNP levels were found to be comparable among groups. Preeclampsia was the most common obstetric problem (11.7 %). We were unable to document significant difference in patients who developed preeclampsia.

Conclusion

Bilateral notch together with abnormal PI measurements in the uterine artery Doppler screening during the second trimester was associated with poor perinatal outcomes. Such an association was not significant in the NT-proBNP measurements. Larger trials focused on late-onset preeclampsia are needed to draw definitive conclusions.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Papageorghiou AT, Yu CK, Nicolaides KH (2004) The role of uterine artery Doppler in predicting adverse pregnancy outcome. Best Pract Res Clin Obstet Gynaecol 18(3):383–396

    Article  PubMed  Google Scholar 

  2. Pijnenborg R, Anthony J, Davey DA, Rees A, Tiltman A, Vercruysse L, van Assche A (1991) Placental bed spiral arteries in the hypertensive disorders of pregnancy. Br J Obstet Gynaecol 98(7):648–655

    Article  CAS  PubMed  Google Scholar 

  3. Brosens I, Dixon HG, Robertson WB (1977) Fetal growth retardation and the arteries of the placental bed. Br J Obstet Gynaecol 84(9):656–663

    Article  CAS  PubMed  Google Scholar 

  4. Tuuli MG, Odibo AO (2011) The role of serum markers and uterine artery Doppler in identifying at-risk pregnancies. Clin Perinatol 38(1):1–19

    Article  PubMed  Google Scholar 

  5. Maisel AS, McCullough PA (2003) Cardiac natriuretic peptides: a proteomic window to cardiac function and clinical management. Rev Cardiovasc Med 4(Suppl 4):S3–S12

    PubMed  Google Scholar 

  6. Raymond I, Groenning BA, Hildebrandt PR, Nilsson JC, Baumann M, Trawinski J, Pedersen F (2003) The influence of age, sex and other variables on the plasma level of N-terminal pro brain natriuretic peptide in a large sample of the general population. Heart 89(7):745–751

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Gundogdu F, Borekci B (2006) Echocardiography and N-terminal pro BNP. J Perinat Med 34(3):253

    Article  PubMed  Google Scholar 

  8. Kale A, Kale E, Yalinkaya A, Akdeniz N, Canoruc N (2005) The comparison of amino-terminal probrain natriuretic peptide levels in preeclampsia and normotensive pregnancy. J Perinat Med 33(2):121–124

    Article  CAS  PubMed  Google Scholar 

  9. Yamada T, Koyama T, Furuta I, Takeda M, Nishida R, Morikawa M, Minakami H (2013) Serum levels of N-terminal fragment of precursor protein brain-type natriuretic peptide (NT-proBNP) in twin pregnancy. Clin Chim Acta 415:41–44

    Article  CAS  PubMed  Google Scholar 

  10. Tanous D, Siu SC, Mason J, Greutmann M, Wald RM, Parker JD, Sermer M, Colman JM, Silversides CK (2010) B-type natriuretic peptide in pregnant women with heart disease. J Am Coll Cardiol 56(15):1247–1253

    Article  CAS  PubMed  Google Scholar 

  11. Folk JJ, Lipari CW, Nosovitch JT, Silverman RK, Carlson RJ, Navone AJ (2005) Evaluating ventricular function with B-type natriuretic peptide in obstetric patients. J Reprod Med 50(3):147–154

    CAS  PubMed  Google Scholar 

  12. Katz R, Karliner JS, Resnik R (1978) Effects of a natural volume overload state (pregnancy) on left ventricular performance in normal human subjects. Circulation 58(3 Pt 1):434–441

    Article  CAS  PubMed  Google Scholar 

  13. Fleming SM, O’Byrne L, Grimes H, Daly KM, Morrison JJ (2001) Amino-terminal pro-brain natriuretic peptide in normal and hypertensive pregnancy. Hypertens Pregnancy 20(2):169–175

    Article  CAS  PubMed  Google Scholar 

  14. Toal M, Keating S, Machin G, Dodd J, Adamson SL, Windrim RC, Kingdom JC (2008) Determinants of adverse perinatal outcome in high-risk women with abnormal uterine artery Doppler images. Am J Obstet Gynecol 198(3):330.e1–330.e7

    Article  Google Scholar 

  15. Von Dadelszen P, Magee LA, Roberts JM (2003) Subclassification of preeclampsia. Hypertens Pregnancy 22(2):143–148

    Article  Google Scholar 

  16. Cnossen JS, Morris RK, ter Riet G, Mol BW, van der Post JA, Coomarasamy A, Zwinderman AH, Robson SC, Bindels PJ, Kleijnen J, Khan KS (2008) Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ 178(6):701–711

    Article  PubMed Central  PubMed  Google Scholar 

  17. Dugoff L, Hobbins JC, Malone FD, Porter TF, Luthy D, Comstock CH, Hankins G, Berkowitz RL, Merkatz I, Craigo SD, Timor-Tritsch IE, Carr SR, Wolfe HM, Vidaver J, D’Alton ME (2004) First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: a population-based screening study (the FASTER Trial). Am J Obstet Gynecol 191(4):1446–1451

    Article  CAS  PubMed  Google Scholar 

  18. Lopez-Quesada E, Vilaseca MA, Vela A, Lailla JM (2004) Perinatal outcome prediction by maternal homocysteine and uterine artery Doppler velocimetry. Eur J Obstet Gynecol Reprod Biol 113(1):61–66

    Article  CAS  PubMed  Google Scholar 

  19. Kleinrouweler CE, Bossuyt PM, Thilaganathan B, Vollebregt KC, Arenas Ramírez J, Ohkuchi A, Deurloo KL, Macleod M, Diab AE, Wolf H, van der Post JA, Mol BW, Pajkrt E (2013) Value of adding second-trimester uterine artery Doppler to patient characteristics in identification of nulliparous women at increased risk for pre-eclampsia: an individual patient data meta-analysis. Ultrasound Obstet Gynecol 42(3):257–267

    Article  CAS  PubMed  Google Scholar 

  20. Campbell S, Black RS, Lees CC, Armstrong V, Peacock JL (2000) Doppler ultrasound of the maternal uterine arteries: disappearance of abnormal waveforms and relation to birthweight and pregnancy outcome. Acta Obstet Gynecol Scand 79(8):631–634

    CAS  PubMed  Google Scholar 

  21. Hernandez-Andrade E, Brodszki J, Lingman G, Gudmundsson S, Molin J, Marsal K (2002) Uterine artery score and perinatal outcome. Ultrasound Obstet Gynecol 19(5):438–442

    Article  CAS  PubMed  Google Scholar 

  22. Resnik JL, Hong C, Resnik R, Kazanegra R, Beede J, Bhalla V et al (2005) Evaluation of B-type natriuretic peptide (BNP) levels in normal and preeclamptic women. Am J Obstet Gynecol 193:450–454

    Article  CAS  PubMed  Google Scholar 

  23. Verlohren S, Melchiorre K, Khalil A, Thilaganathan B (2014) Uterine artery Doppler, birth weight and timing of onset of pre-eclampsia: providing insights into the dual etiology of late-onset pre-eclampsia. Ultrasound Obstet Gynecol 44(3):293–298

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors stated that they did not have conflict of interests.

Author information

Affiliations

  1. Ege (Aegean) Maternity and Gynecology Training and Research Hospital, Izmir, Turkey

    İbrahim Uyar, Sefa Kurt, Tutku Gurbuz, Onur Suleyman Aldemir, Buket Keser & Abdullah Tasyurt

  2. Medical Faculty Hospital, Department of Obstetrics and Gynecology, Pamukkale University, Denizli, Turkey

    Ömer Demirtaş

Authors
  1. İbrahim Uyar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sefa Kurt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ömer Demirtaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tutku Gurbuz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Onur Suleyman Aldemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Buket Keser
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Abdullah Tasyurt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ömer Demirtaş.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Uyar, İ., Kurt, S., Demirtaş, Ö. et al. The value of uterine artery Doppler and NT-proBNP levels in the second trimester to predict preeclampsia. Arch Gynecol Obstet 291, 1253–1258 (2015). https://doi.org/10.1007/s00404-014-3563-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-014-3563-3

Keywords

  • NT-proBNP
  • Uterine artery doppler
  • Perinatal outcome