Biomedical subjects

B Thilaganathan

Publications and source records attributed to B Thilaganathan.

At least 19 recordsLinked to original sources

PubMed2007

Uterine artery Doppler velocimetry at 11-14 weeks in singleton pregnancies conceived by assisted reproductive technology.

OBJECTIVE: Singleton pregnancies resulting from assisted reproductive technologies (ART) have an increased risk of preterm delivery, pre-eclampsia and intrauterine growth restriction. The aim of the present study was to determine whether first-trimester trophoblastic invasion, as assessed by uterine artery Doppler velocimetry, is different in singleton pregnancies resulting from ART compared to those conceived naturally. METHODS: Case-control study on 31 singleton ART pregnancies (26 in-vitro fertilization-embryo transfer, five intracytoplasmic sperm injection) and 62 matched pregnancies conceived spontaneously. Doppler velocimetry was performed at 11-14 weeks of gestation. RESULTS: The mean resistance index (coefficient of variation) was 0.70 (17%) and 0.70 (18%) in ART and controls, respectively (P = 0.92). The corresponding values for mean pulsatility index were 1.40 (44%) and 1.47 (44%) in ART and controls, respectively (P = 0.58). Pregnancies with no, unilateral or bilateral diastolic notches were 48%, 26%, 26% and 36%, 37%, 27%, in ART and controls, respectively (P = 0.43). CONCLUSION: There are no differences in uterine artery Doppler indices between pregnancies obtained by invasive ART and naturally conceived matched controls. This finding suggests that there is no major difference in trophoblastic invasion of the maternal spiral arteries between ART and spontaneous pregnancies.

Adult↗

PubMed2007

Maternal cardiac function in early pregnancies with high uterine artery resistance.

OBJECTIVE: To compare the maternal cardiac function and serum concentration of cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in first-trimester patients, according to uterine artery Doppler velocimetry (UADV). METHODS: This cross-sectional study included singleton pregnancies with normal UADV (n=17) and abnormal UADV (n=19). Maternal echocardiography was performed and blood samples were taken at 11-14 weeks. Echocardiographic parameters included: (a) left ventricular (LV) long axis velocities; (b) atrial size; (c) LV filling pressure; (d) the ratio of peak mitral flow velocity in early diastole and early mitral annular diastolic velocity (E/Ea ratio); and (e) the E/flow propagation velocity ratio. The maternal serum concentrations of cTnT and NT-proBNP were determined by sensitive and specific immunoassays. RESULTS: Patients with abnormal UADV had higher estimated left ventricular filling pressure (P=0.004), higher E/Ea ratio (P=0.03), higher E/flow propagation ratio (P=0.02), and lower LV long axis velocity (P=0.02) than those with normal UADV. There were no significant differences in the maternal serum concentration of cTnT or NT-proBNP. CONCLUSIONS: Patients with abnormal UADV in the first trimester have higher left ventricular filling pressure and may have left ventricular systolic dysfunction.

Adult↗

PubMed2007

First-trimester uterine artery Doppler and spontaneous preterm delivery.

OBJECTIVES: To assess the relationship between first-trimester uterine artery Doppler measurements and spontaneous preterm delivery. METHODS: This was a retrospective analysis of uterine artery Doppler findings at 11-14 weeks in 73 singleton pregnancies with spontaneous preterm labor and 2417 pregnancies delivered at term. RESULTS: The uterine artery mean resistance index (RI) was 0.68 (coefficient of variation 19%) and 0.69 (17%) in the preterm and term delivery groups, respectively (P = 0.35). The mean pulsatility index (PI) was 1.42 (39%) and 1.42 (46%) in the term and preterm delivery groups, respectively (P = 0.95). Bilateral diastolic notches were present in 34% of preterm deliveries and 33% of controls (P = 0.84). Restricting the analysis to the 19 pregnancies with preterm delivery before 34 weeks of gestation, no significant difference from controls was observed for RI (mean 0.71, coefficient of variation 11%, P = 0.41), PI (mean 1.56, coefficient of variation 29%, P = 0.27) or the number of bilateral notches (42%, P = 0.41). CONCLUSIONS: Despite pathological evidence suggesting that defective placentation is associated with spontaneous preterm delivery, first trimester uterine artery resistance, as assessed by Doppler ultrasound investigation, is not different in pregnancies subsequently complicated by preterm labor compared to pregnancies delivered at term. This finding may be explained by a late failure of trophoblast development in cases destined to deliver preterm.

Adult↗

PubMed2006

Effect of first-trimester serum from pregnant women with high-resistance uterine artery Doppler resistance on extravillous trophoblast invasion.

BACKGROUND: Abnormal uterine artery Doppler indices are associated with pregnancy complications such as pre-eclampsia and intrauterine growth restriction. Poor trophoblast invasion may be a consequence of, or be associated with, abnormal Doppler indices. OBJECTIVE: To evaluate in vitro trophoblast function following exposure to first-trimester serum from pregnancies with high uterine artery Doppler resistance indices. METHODS: Doppler ultrasound examination of the maternal uterine arteries was performed on women at 10-14 weeks' gestation. Serum was collected from women with bilateral uterine artery notches with resistance indices above the 95th centile and from patients with normal uterine artery indices. The effect of serum on trophoblast invasion was determined using an established in vitro model from the extravillous trophoblast-derived cell line SGHPL-4. RESULTS: Trophoblastic invasion was significantly reduced when treated with serum from women with high-resistance compared with normal-resistance uterine artery Doppler indices (P < 0.05). CONCLUSION: Maternal serum in the first trimester of pregnancy from patients with high-resistance uterine artery Doppler indices appears to inhibit trophoblast invasion. This experimental model allows further investigation of factors responsible and the evaluation of therapeutic strategies.

Adult↗

PubMed2006

Doppler and biophysical assessment in growth restricted fetuses: distribution of test results.

OBJECTIVE: Multi-vessel Doppler ultrasonography and biophysical profile scoring (BPS) are used in the surveillance of growth restricted fetuses (IUGR). The interpretation of both tests performed concurrently may be complex. This study examines the relationship between Doppler ultrasonography and biophysical test results in IUGR fetuses. METHODS: Three hundred and twenty-eight IUGR fetuses (abdominal circumference < 5th percentile, elevated umbilical artery (UA) pulsatility index (PI)) had concurrent surveillance with UA, middle cerebral artery (MCA) and ductus venosus (DV) Doppler ultrasonography and BPS (fetal tone, movement, breathing, maximal amniotic fluid pocket and fetal heart rate). Patients were stratified into three groups according to their Doppler examination: (1) abnormal UA alone; (2) brain sparing (MCA-PI > 2 SD below mean for gestational age); and (3) abnormal DV (PI > 2 SD above the mean for gestational age) and BPS groups: (1) normal (> 6/10); (2) equivocal (6/10); and (3) abnormal (< 6/10). Predictions of short-term perinatal outcomes by both modalities were compared for stratification. The distribution and concordance of Doppler and BPS test results were examined for the whole patient group and based on delivery prior to 32 weeks' gestation. RESULTS: Abnormal UA Doppler results alone were observed in 109 fetuses (33.2%), brain sparing in 87 (26.5%) and an abnormal DV in 132 (40.2%). The BPS was normal in 158 (48.2%), equivocal in 68 (20.7%) and abnormal in 102 (31.1%). Both testing modalities stratified patients into groups with comparable acid-base disturbance and perinatal outcome. Of the nine possible test combinations the largest subgroups were: abnormal UA alone/normal BPS (n = 69; 21%) and abnormal DV Doppler/abnormal BPS (n = 62; 18.9%). Assessment of compromise by both testing modalities was concordant in 146 (44.5%) cases. In 182 fetuses with discordant results the BPS grade was better in 115 (63.2%, P < 0.0001). Marked disagreement of test abnormality was present in 57 (17.4%) fetuses. Of these, abnormal venous Doppler in the presence of a normal BPS constituted the largest group (Chi-square P < 0.002). Stratification was not significantly different in patients delivered prior to 32 weeks' gestation. CONCLUSION: Doppler ultrasonography and BPS effectively stratify IUGR fetuses into risk categories, but Doppler and BPS results do not show a consistent relationship with each other. Since fetal deterioration appears to be independently reflected in these two testing modalities further research is warranted to investigate how they are best combined.

Adolescent↗

PubMed2006

Do early pregnancy ultrasound measurements correlate with fetal nuchal translucency at 11-14 weeks?

OBJECTIVE: To assess whether extremes in nuchal translucency (NT) thickness measurements at 11-14 weeks of gestation are preceded by departures from normal in early ultrasound biometry or embryonic heart rate in euploid fetuses. METHODS: This was a retrospective analysis of data from women with singleton pregnancies examined in early pregnancy between June 2002 and January 2003, who subsequently had a nuchal translucency (NT) scan. The early pregnancy scan was performed transvaginally, and the crown-rump length (CRL), mean gestational sac diameter (GS), mean yolk sac diameter (YS) and embryonic heart rate (HR) were measured where possible. At the second scan CRL and NT were measured. RESULTS: A total of 534 singleton pregnancies were included in the analysis. The mean maternal age was 30 (range, 14-45) years, and 59.4% of the patients were nulliparous. The mean CRL was 11.5 (range, 1.4-30.0) mm at the first scan and 62.8 (range, 42.0-88.0) mm at the second scan. GS, YS and HR measurements were obtained in 87.6%, 72.5% and 72.5% of cases, respectively. No statistically significant correlation was observed between NT and Z-scores of early pregnancy: GS (r = 0.013, P = 0.77), YS (r = 0.039, P = 0.44) or HR (r = 0.016, P = 0.76). GS, YS and HR were not significantly different in fetuses with NT measurements below the 10th percentile or above the 90th percentile (P = 0.24, 0.84 and 0.60, respectively). CONCLUSION: Ultrasound biometry and heart rate measured in early pregnancy are not related to nuchal translucency measurements at 11-14 weeks of gestation in chromosomally normal fetuses.

Adolescent↗

PubMed2006

Effect of inter-twin delivery interval on neonatal haemoglobin concentration.

The aim of this study was to examine the effect of the inter-twin delivery interval on neonatal haemoglobin concentration. We retrospectively analysed 108 twin deliveries over a 5-year period. Chorionicity was determined by first trimester ultrasound or placental histopathology. The mode of delivery, time of delivery and cord/neonatal blood counts were recorded. A total of 88 sets of dichorionic and 20 sets of monochorionic twins were studied. There was no correlation between inter-twin delivery interval and haemoglobin difference (rho = 0.020, p = 0.857). In monochorionic twin pregnancies, there was a trend towards increasing inter-twin hemoglobin differences with prolonged delivery intervals. However, this trend did not reach statistical significance (rho = -0.303, p = 0.193). In monochorionic twins, there is a trend towards a lower haemoglobin concentration in the twin delivered second. This haemoglobin deficit appears to be related to the inter-twin delivery interval.

Delivery, Obstetric↗

PubMed2005

Fetal congenital cardiac diverticulum with pericardial effusion: two cases with different presentations in the first trimester of pregnancy.

Two cases of fetal congenital cardiac diverticula diagnosed at 14 and 12 weeks of gestation are reported. Both presented with a large pericardial effusion. One fetus presented with increased NT which evolved into fetal hydrops. Pericardiocentesis at 16 weeks led to progressive resolution of hydrops. The other showed no hemodynamic compromise, normal nuchal translucency (NT) and spontaneous regression of the effusion. Both children were well at 22 and 17 months of age at the time of writing.

Adult↗

PubMed2005

The sensitivity of antenatal ultrasound for predicting renal tract surgery in early childhood.

OBJECTIVE: To establish the sensitivity of antenatal ultrasound for identifying the need for renal tract surgery in infancy and early childhood. METHODS: A retrospective analysis of the surgical records in children under 5 years of age undergoing renal tract surgery in a regional pediatric urological surgery referral unit was carried out. All records between May 1997 and July 2002 were examined to assess the relationship between prenatal ultrasound findings and postnatal surgical pathology. RESULTS: A total of 106 operations had been performed. The detection rate of multicystic renal dysplasia was 100% (17/17). The equivalent detection rates for pelviureteral junction obstruction, duplex renal system and vesicoureteral reflux were 82.8, 67 and 26.1%, respectively. None of the babies with renal tumors had abnormal antenatal ultrasound findings. The diagnosis of postnatal renal surgical pathology was made on the basis of prenatal scan findings in 59.6% of cases, while recurrent urinary tract infection led to the diagnosis in 26.0%. CONCLUSIONS: Approximately 40% of children requiring surgery for renal tract pathology will have a normal antenatal ultrasound examination. The prevalence of abnormal antenatal ultrasound findings varies depending on the type of renal tract pathology. Despite these findings, the commonest indicator for surgery remains abnormal prenatal scan findings, followed by recurrent urinary tract infections.

Child, Preschool↗

PubMed2005

Neonatal outcome of antenatally diagnosed congenital cystic adenomatoid malformations.

OBJECTIVE: To investigate the natural history and outcome of antenatally diagnosed congenital cystic adenomatoid malformation (CCAM) of the lung. METHODS: This was a retrospective study of all cases of fetal CCAM of the lung diagnosed antenatally. All cases were referred to a tertiary center for further management. A computer search identified all referred cases, and the records of these patients were examined to determine the pregnancy outcome. RESULTS: In a 4-year period, 34 cases of fetal CCAM were referred for further management. At presentation, all the cases were noted to be unilateral CCAMs and the majority (79%) were microcystic in nature. The CCAMs were complicated by varying degrees of mediastinal shift (79%) and hydrops fetalis (18%). During the course of the pregnancy, the lung lesion was seen to reduce in size or resolve spontaneously in 76% of cases without any prenatal intervention (including resolution of hydrops in three cases). The overall survival rate into infancy was 88%. One pregnancy was terminated for persisting hydrops fetalis and another resulted in infant death from complications of neonatal cardiac surgery for an associated aortic coarctation. CONCLUSION: The outcome of antenatally detected CCAM is much better than previously reported even when complicated by hydrops fetalis at presentation. The latter seems to be related to the high spontaneous regression rate of this tumor. Despite the antenatal resolution of CCAMs on ultrasound, postnatal follow-up is recommended in view of the long-term complications of this malformation.

Cystic Adenomatoid Malformation of Lung, Congenita↗

PubMed2005

A newly described thoracic vascular malformation in fetuses with Down syndrome.

OBJECTIVES: To report the association between thoracic vascular malformations observed in the first trimester of pregnancy and Down syndrome. METHODS: The clinical features were reviewed of seven fetuses undergoing chorionic villus sampling (CVS) for increased nuchal translucency (NT) thickness, in which color Doppler ultrasonography revealed a vascular malformation in the fetal thorax. RESULTS: The crown-rump length of the fetuses ranged from 58 to 78 mm and NT measurements ranged from 2.9 to 10.0 mm. Color Doppler allowed the identification of a highly vascular structure in the posterolateral portion of the fetal thorax, in proximity to the costovertebral angle, at the level of a four-chamber view of the heart. The lesions had a globular shape and were 4-6 mm in diameter, occupying almost one third of the hemithorax. Down syndrome was diagnosed in five out of the seven cases. In the only affected case that underwent postmortem examination, a hemangioma of the chest wall was demonstrated. In the two fetuses with normal karyotype, the lesion disappeared by mid-gestation. CONCLUSION: We report an association between the prenatal Doppler finding of a vascular tumor in the fetal chest and Down syndrome.

Cardiovascular Abnormalities↗

PubMed2004

Natural history and outcome of prenatally diagnosed cystic hygroma.

OBJECTIVE: To define the outcome in cases of cystic hygroma diagnosed from a routine obstetric population. METHOD: This was a retrospective study of 42 cases of fetal cystic hygroma detected at 11 to 23 weeks' gestation in a routine obstetric population of 25 352 pregnancies. Fetal cystic hygroma was categorized according to position, severity, presence of cardiac defects and Hydrops fetalis. RESULTS: There were 20 (47.6%) cases with aneuploidy (9 trisomies and 11 Turner's syndrome). Major congenital cardiac defects were identified in 12 (28.6%) cases. Regression of the hygroma was noted in 2/20 (10%) of the aneuploid pregnancies and 3/17 (17.6%) of the euploid pregnancies. The majority (90.0%) of the aneuploid fetuses were female. In contrast, 70.58% of the fetuses in the euploid group were male and all the surviving normal babies were also male (n = 3). CONCLUSION: The findings of this study would support invasive prenatal diagnosis for an ultrasound finding of fetal cystic hygroma. Even in euploid pregnancies with cystic hygroma, there is a high mortality with associated abnormalities. The data also suggest a guarded pregnancy prognosis for the finding of fetal cystic hygroma, and that it is improved with spontaneous resolution, especially in male fetuses of normal karyotype.

Aneuploidy↗

PubMed2004

Second-trimester uterine artery Doppler and spontaneous preterm delivery.

OBJECTIVE: To assess the relationship between second-trimester uterine artery (UtA) Doppler measurements and spontaneous preterm delivery. METHODS: This was a retrospective analysis of UtA Doppler findings at 18-23 weeks' gestation in 234 singleton pregnancies with spontaneous preterm labor and 5472 pregnancies delivered at term. Cases with fetal chromosomal or structural abnormalities, pre-eclampsia, small-for-gestational-age (SGA) fetuses, concurrent maternal disease, cervical cerclage or history of cone biopsy were excluded. RESULTS: UtA mean resistance index (RI) and number of protodiastolic notches were not significantly different in the spontaneous preterm labor group compared to the normal group. The 62 preterm deliveries not preceded by spontaneous preterm premature rupture of membranes (PPROM) showed a significantly higher RI and prevalence of bilateral notches than cases of preterm deliveries preceded by PPROM (n = 172). However, this difference was not confirmed in a logistic regression model. CONCLUSION: Despite pathological evidence suggesting that defective placentation is associated with spontaneous preterm delivery, second-trimester UtA resistance, as assessed by Doppler ultrasound investigation, is not different in pregnancies subsequently complicated by preterm labor compared to pregnancies delivered at term.

Adult↗

PubMed2004

Effect of parity on second-trimester uterine artery Doppler flow velocity and waveforms.

OBJECTIVES: To investigate the relationship between second-trimester uterine artery Doppler findings and parity in a large pregnant population. METHODS: Uterine artery Doppler studies were performed in all singleton pregnancies at 18-23 weeks of gestation. The mean uterine artery resistance index and the presence or absence of protodiastolic notches were recorded. Two groups were identified: pregnancies not complicated by pre-eclampsia, and pregnancies with pre-eclampsia severe enough to require delivery at or before 32 weeks of gestation. RESULTS: In the 4132 pregnancies uncomplicated by pre-eclampsia, parity was shown to be an independent predictor for both mean uterine artery resistance index (beta = 0.073, P < 0.001) and the presence of bilateral protodiastolic notches (odds ratio = 0.67; 95% CI, 0.45-0.98). In the 17 pregnancies complicated with severe pre-eclampsia, uterine artery Doppler indices showed a trend towards being better predictors of disease in nulliparous compared with parous women. CONCLUSION: Parity has a significant effect on the resistance index and the prevalence of protodiastolic notching in the uterine artery flow waveforms. This difference is clinically noticeable in its effect on notching. These findings suggest that some permanent modification may persist in the maternal vessels after a successful pregnancy, altering their impedance in subsequent pregnancies.

Adult↗

PubMed2004

Decreased endovascular trophoblast invasion in first trimester pregnancies with high-resistance uterine artery Doppler indices.

BACKGROUND: Defective trophoblastic invasion in early pregnancy is involved in the pathogenesis of pre- eclampsia. This study investigates the relationship between Doppler assessment of uterine artery resistance and endovascular trophoblastic invasion in the first trimester of pregnancy. METHODS: Patients undergoing termination of pregnancy for non-medical reasons were categorized as having a low- or high-resistance uterine artery blood flow pattern by transabdominal Doppler ultrasound. Products of conception were examined histologically with regard to the extent of decidual endovascular trophoblast invasion. RESULTS: There were 14 low-resistance and 17 high-resistance uterine artery blood flow pregnancies identified at 10-14 weeks of gestation. Normal intradecidual endovascular trophoblast invasion was identified with a similar frequency in both groups (P=0.79). However, the proportion of decidual vessels with endovascular trophoblast invasion was significantly higher in the low-resistance pregnancies (49%) compared with the high-resistance ones (34%, P=0.02). CONCLUSIONS: The findings of this study support the use of uterine artery Doppler investigation for the non-invasive assessment of trophoblast invasion in early pregnancy. Further studies are necessary to clarify the biological significance of these observations and their potential clinical applications.

Adult↗

PubMed2004

Clinical impact of first and early second trimester fetal echocardiography on high risk pregnancies.

OBJECTIVE: To evaluate the clinical impact of fetal echocardiography before 16 weeks' gestation on the management of pregnancies with fetuses at risk of congenital heart disease. DESIGN AND SETTING: Observational study in a fetal medicine unit. PARTICIPANTS AND METHODS: 222 consecutive women with high risk pregnancies (230 fetuses) underwent transabdominal fetal echocardiography at a median gestation of 14(+1) weeks. For 10%, transvaginal scans were also performed. Criteria for normal scans were normal sequential segmental analysis, symmetrical four chamber view, normal semilunar valves, arterial outflow tracts, and ductal and aortic arches. Early scans were compared with mid-second trimester fetal echocardiography. Postmortem and postnatal data were added. Adverse pregnancy outcomes were diagnosis of a major cardiac or extracardiac abnormality, chromosomal defects, intrauterine death, or termination of pregnancy. RESULTS: There were 21 abnormal cardiac scans (9%): 14 major structural defects (eight isolated, six with chromosomal or extracardiac abnormalities) in pregnancies resulting in three live births, one intrauterine death, and 10 terminated pregnancies. Seven scans showed asymmetry between right and left sided structures (two isolated, five with chromosomal or extracardiac abnormalities); six of the seven pregnancies were terminated. The scans were normal in 199 cases (87%). Cardiac follow up of 184 of 199 babies (93%) confirmed situs and connections. One case each of pulmonary stenosis and ventricular septal defect requiring postnatal intervention were diagnosed at later scans. In 28 of 199 (14%) babies there was a non-cardiac adverse outcome. First examination was not diagnostic for 10 (4%). CONCLUSION: Early fetal echocardiography in high risk pregnancies was diagnostic in 96%. Abnormal cardiac scans (isolated in 48%, major structural defects in 67%) led to termination of pregnancy in 76%. Most cardiac scans were normal, allowing family reassurance. The high number of adverse outcomes with normal cardiac anatomy stresses the need for a multidisciplinary approach to early fetal echocardiography.

Echocardiography, Doppler, Color↗

PubMed2003

Nuchal translucency thickness measurement: repeatability using a virtual ultrasound scanner.

AIM: To use a PC-based virtual ultrasound scanner (VirUS) in the investigation of inter- and intraoperator nuchal translucency (NT) thickness measurement repeatability of experienced ultrasound operators. METHODS: Realistic fetal ultrasound images of defined NT thickness were simulated with VirUS with emulation of scanner gain and time-gain compensation and gain-dependent echo size changes. A set of 50 images was generated with uniformly distributed NT thickness (range, 1-5 mm at 1-mm intervals) and translucency angle (mean +/- standard deviation of +/- 2.52 degrees +/- 1.85 degrees about the horizontal). Operators (n = 13) measured NT thickness in the image set on three occasions separated by at least 1 day, giving 150 measurements per operator (total measurements, 1950). RESULTS: Inter- and intraoperator repeatabilities were +/- 0.41 mm and +/- 0.22 mm, respectively (at the 95% confidence level). There were significant correlations between repeatability and mean measured NT thickness (r = - 0.72, P = 0.005 at 4-mm interval), between gain and mean measured NT thickness (P </= 0.002, n = 8/13) and between gain and repeatability coefficient (P < 0.01, n = 6/13). DISCUSSION: VirUS provides a consistent NT audit environment and demonstrates the need to both optimize repeatability vs. mean measured thickness and to set gain consistently. The technique has potential in operator training.

Computer Simulation↗

PubMed2003

First-trimester uterine artery blood flow and birth weight.

OBJECTIVES: To determine reference values for first-trimester uterine artery resistance index (RI) in healthy pregnant women with uncomplicated pregnancies and to investigate the relationship between uterine artery Doppler indices and birth weight. METHODS: This was a cross-sectional study of 265 consecutive pregnant women attending routine ultrasound examination at 11-14 weeks' gestation. Both uterine arteries were identified using color Doppler ultrasound and the RI was measured. The presence or absence of an early diastolic notch was also noted. Pregnancy outcomes were obtained from the delivery suite database and birth weight was expressed as Z-scores. RESULTS: The 5(th), 50(th) and 95(th) centiles for uterine artery RI between 11 and 14 weeks' gestation were 0.53, 0.71 and 0.85, respectively. Complete pregnancy outcome data were available for 246 fetuses. There was a significant negative correlation between birth-weight Z-scores and first-trimester uterine artery mean RI (r = - 0.219, P = 0.001). The difference in birth weight between fetuses with absent and those with bilateral diastolic notches was also significant (P < 0.001). Multiple regression analysis demonstrated that both mean RI (standardized regression coefficient = - 0.14, P = 0.039) and uterine artery notching (standardized regression coefficient = - 0.17, P = 0.017) contributed independently towards the prediction of birth-weight Z-score. CONCLUSIONS: A significant negative correlation exists between birth weight and first-trimester uterine artery Doppler parameters, a reliable and non-invasive method of examining uteroplacental perfusion. The value of first-trimester uterine artery Doppler as a prognostic screening tool, either in isolation or in conjunction with maternal biochemistry, remains to be determined.

Adolescent↗