الفهرس 
Preeclmpsia
Criteria for patient selectionOnly 14 pages are availabe for public view
 |  | from | 155 |  |  |
| | | from | 155 | | |
Abstract
Pre-eclampsia and intrauterine growth restriction remain important causes of maternal and neonatal complications and death. These 2 conditions are felt to be the result of abnormal placental formation involving abnormal trophoblast invasion of spiral arteries and reduction in vascular resistance in the uteroplacental circulation. This has led to the idea of using Doppler ultrasonography to assess the velocity of uterine & spiral artery blood flow as part of routine ultrasound screening. 3D power Doppler angiography (PDA) is a noninvasive and safe way to study blood flow within an organ or region of interest .Direct investigation of the placental perfusion has become possible using(PDA) Several studies have suggested that parameters derived from 3Dpower Doppler evaluation of the placenta in the first trimester can predict adverse pregnancy outcomes including preeclampsia (PE) and fetal growth restriction. This research aimed to study the role of first trimester colour Doppler of uterine & spiral arteries blood flow together with 3D power Doppler angiography of uteroplacental circulation space in prediction of pre eclampsia & intrauterine growth restriction in high risk pregnant women. This prospective controlled study was carried on 60 patients attended the outpatient clinic department of Obstetrics & Gynaecology Tanta university hospital & Cairo University Hospital. The participants was classified into two groups: Study group: consisted of 40 women (2nd &3rd gravida) with high risk of preeclampsia& intrauterine growth restriction in their previous pregnancy, attended the outpatient clinic Control group: consisted of 20 women (2nd &3rd gravid) in their 1st trimester of pregnancy, having uneventable pregnancy, attending the outpatient clinic for routine antenatal care Transvaginal Ultrasonographic Examination including color- Doppler to assess the following data: Gestational age. Fetal viability. Maximum chorionic condensation & future placentation. Colour Doppler & resistive index (RI) of the retro chorionic (spiral blood flow). Colour Doppler & RI of the uterine arteries. 3D power Doppler angiography of the uteroplacental circulation space to assess & calculate the 3D power Doppler indices: the vascularization indices (VF), flow indices (FI) & vascular flow index(VFI) of this circulation We found that first-trimester uterine artery RI in women destined to pre-eclampsia, were significantly different from those in normal pregnancies being higher in preeclamptic women which came in agreement of studies have prospectively evaluated the role of firsttrimester uterine artery Doppler in large populations Our results showed that indices of impedance to flow of the spiral arteries were significantly lower in cases complicated by preeclampsia than normal pregnancy. In the present study, we demonstrated that the 3D power Doppler indices are significantly correlated with preeclampsia. In our assessment, all three placental vascular indices were significantly lower in placentas with preeclampsia compared with normal pregnancies when the evaluation is done between 7 and 11 weeks. The conclusion is that large global studies should be done for more evaluation of these predictive methods for early detection of preeclampsia & intrauterine resrtiction growth.