Can Serum Biomarker Values from Second-Trimester Aneuploidy Screening Predict the development of Retinopathy of Prematurity in Premature Infants?

Objectives: This study aimed to evaluate serum biomarker values measured during second-trimester aneuploidy screening in terms of their predictive ability for the development of retinopathy of prematurity (ROP) in premature infants. Methods: This retrospective cohort study evaluated the data of 1985 idiopathic premature infants who underwent ROP screening from 2016 to 2022. The infants were divided into two groups according to the presence of ROP, and those with ROP were further evaluated in two subgroups based on the presence of proliferation. Comparisons were made concerning the serum multiple of the median values of unconjugated estriol (uE3), human chorionic gonadotropin (hCG), and alpha-fetoprotein (AFP) among aneuploidy screening biomarkers. Results: While 1628 premature infants were in the non-ROP group, 357 were in the ROP group. Of the infants with ROP, 72 were in the proliferative ROP group and 285 in the non-proliferative ROP group. There was no significant difference in the multiple of the median values of the evaluated serum biomarkers (uE3, hCG, and AFP) between the ROP and non-ROP groups or between the proliferative ROP, non-proliferative ROP, and non-ROP groups. Conclusion: The multiple of the median values of second-trimester aneuploidy screening serum biomarkers were not able to predict the development of ROP in premature infants. This result may have been caused by the fact that the blood tests were taken only once and in the same weeks.

Foetal cardiac function in third trimester pregnancies with reduced fetal movements.

The objective of our study was to investigate the possible relationship between poor perinatal outcome and foetal cardiac functions in pregnant women with reduced foetal movements (RFM). This cross-sectional study included 126 pregnant women with normal foetal movements (Group 1, Controls) and 42 pregnant women over 32 weeks gestation with RFM (Group 2). Group 2 was further divided into two subgroups according to their perinatal outcome: normal perinatal outcome (Group 2a) and poor perinatal outcome (Group 2b). Cardiotocography, the E/A ratio in both atrioventricular valves, myocardial performance index (MPI) and foetal tricuspid annular plane systolic excursion (f-TAPSE) were evaluated. Foetuses with poor perinatal outcome had a higher MPI (p = .003), higher tricuspid and mitral E/A (p < .001), and lower f-TAPSE values (p < .001). In regression analysis, f-TAPSE was the only parameter (p = .04) independently associated with poor perinatal outcome. In conclusion, examining f-TAPSE may predict adverse perinatal outcome in pregnancies with RFM.IMPACT STATEMENTWhat is already known on this subject? Reduced foetal movement (RFM) is associated with adverse pregnancy outcome. Cardiotocography, amniotic fluid assessment, estimated birthweight, foetal Doppler and formal foetal movement count (kick chart) are generally used in the clinical assessment of pregnancies with reduced foetal movements. These tests, we currently use to assess foetal wellbeing in women with reduced foetal movements, have limited sensitivity in predicting foetal compromise.What do the results of this study add? Foetal cardiac Doppler may potentially be used as an important adjunct to the conventional management of women with a perception of reduced foetal movements.What are the implications of these findings for clinical practice and/or further research? Foetal echocardiographic evaluation, such as f-TAPSE, may influence clinical practice by enabling improved risk stratification for poor perinatal outcome, thus allowing more timely definitive intervention. This could help to decrease the rate of stillbirth related to reduced foetal movements. The few established echocardiographically derived parameters, which can asses global right ventricle function, are not always easy to obtain, however, f-TAPSE is easily obtainable using ultrasound and it appears to be a clinically useful echocardiographic measurement of right ventricular function.

P-Wave Dispersion and Atrial Electromechanical Delay in Patients with Preeclampsia.

OBJECTIVES: To investigate the duration of atrial electromechanical delay (EMD) and left atrial mechanical function in patients with preeclampsia. MATERIALS AND METHODS: This study included 26 pregnant women with preeclampsia and 24 age-matched pregnant women without preeclampsia (control group). Atrial electromechanical coupling (PA) and intra-atrial and interatrial EMD were measured using tissue Doppler echocardiography. P-wave dispersion (PWD) was measured via 12-lead electrocardiography. All data were analyzed using SPSS v.15.0 for Windows (SPSS, Inc., Chicago, Ill., USA). Differences in continuous variables between groups were examined using a nonparametric Mann-Whitney U test. Correlation analysis was performed using Spearman's coefficient of correlation. Categorical values were compared using a χ2 test. RESULTS: PA lateral and PA septal durations were significantly longer in the preeclampsia group than in the control group [74.6 ± 8.1 vs. 62.3 ± 5.3 ms (p < 0.001) and 59.7 ± 5.3 vs. 56.2 ± 4.9 ms (p = 0.005), respectively]. The duration of interatrial EMD and intra-atrial EMD in the preeclampsia group was significantly longer than in the control group [25.4 ± 4.6 vs. 13.2 ± 3.9 ms (p < 0.001) and 10.5 ± 1.9 vs. 7.1 ± 1.2 ms (p < 0.001), respectively]. PWD was significantly higher in patients with preeclampsia (43.1 ± 9.1 ms) than in the controls (37.6 ± 7.9 ms; p = 0.008). There was a significant correlation between PWD and interatrial EMD and intra-atrial EMD [r = 0.46 (p < 0.001) and r = 0.39 (p < 0.001), respectively]. CONCLUSION: The duration of atrial EMD and PWD was prolonged in patients with preeclampsia.