Second trimester uterine arteries pulsatility index is a function of placental pathology and provides insights on stillbirth aetiology: A multicenter matched case-control study
Open accessAbstract
Introduction The aim of this study was to investigate the relationships between maternal vascular malperfusions (MVM) and second trimester uterine arteries pulsatility index (UtA-PI) in cases of stillbirth (SB), compared to live-birth (LB) matched controls.Methods This was a multicentre, observational, matched case-control study performed at five referral maternity centres over a 4-year period including SB and LB control pregnancies at high-risk for preeclampsia (PE) and/or fetal growth restriction (FGR), matched and stratified for UtA-PI MoM quartiles values of the SB cases. Logistic regression was used to assess the rates of each MVM finding, within each increasing MoM quartile subcategory in SB and matched LB controls.Results 82 SB and 82 LB matched high-risk pregnancies were included. Placental hypoplasia, placental infarction, retroplacental hematoma, distal villous hypoplasia and accelerated villous maturation showed a significant correlation with UtA-PI. At univariable analysis, placental infarction and distal villous hypoplasia were more highly associated with the increasing quartile uterine Doppler measurements (odds ratio 2.24 and 2.23, respectively). Logistic regressions showed a significant positive and independent association between rates of retroplacental hematoma or distal villous hypoplasia and stillbirth within corresponding UtA-PI MoM quartiles (odds ratio 5.21 and 2.28, respectively).Discussion We are providing evidence for characterization of two major etiological stillbirth categories, characterized by a positive or absent association with UtA-PI impairment and specific histopathological placental MVM lesions. Our results support a strict third trimester follow-up of cases with increased second trimester UtA-PI, in order to improve the reproductive chances of these pregnant patients.
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Uterine artery Doppler velocimetry is associated with the development of preeclampsia and placental pathology.
“Ultrasound can be used to measure Doppler velocimetry in the uterine artery, which is associated with development of preeclampsia and placental pathology21,22”
From Multi-centre deep learning for placenta segmentation in obstetric ultrasound with multi-observer and cross-country generalization (2023) · cites this paper as [21]
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- Authors
- Amodeo, S., Cavoretto, P. I., Seidenari, A., Paci, G., Germano, C., Monari, F., Donno, V., Giambanco, L., Avagliano, L., Di Martino, D., Fusé, F., Masturzo, B., Chiantera, V., Facchinetti, F., Ferrazzi, E., Candiani, M., Bulfamante, G., & Farina, A.
- Affiliations
- University of Palermo (IT)
- Vita-Salute San Raffaele University (IT)
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- Ospedale Sant'Anna (IT)
- University of Modena and Reggio Emilia (IT)
- University of Milan (IT)
- Corresponding author
- Farina, Antonio
- ORCID
- Venue
- Placenta
- Publisher
- Elsevier BV
- Published
- 2022-04
- Volume
- 121
- Pages
- 7-13
- ISSN
- 0143-4004 (ISSN-L)
- OpenAlex
- W4214508513
- Cited by
- 21
- References
- 29
- Citations by year
- 2026: 2 · 2024: 5 · 2023: 9 · 2022: 5
- FWCI
- 4.79
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Placenta (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by-nc-nd)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- stillbirth, uterine artery pulsatility index, placental pathology, placental infarction, retroplacental hematoma, placental hypoplasia, maternal vascular malperfusion, preeclampsia, fetal growth restriction
- MeSH terms
- Female, Hematoma, Humans, Infarction, Placenta, Pre-Eclampsia, Pregnancy, Pregnancy Trimester, Second, Pulsatile Flow, Case-Control Studies, Ultrasonography, Prenatal, Stillbirth, Uterine Artery
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