The relatıonshıp between maternal serum a- fetoproteın and uterıne artery doppler fındıngs at 20-24 weeks' gestatıon for predıctıon of preeclampsıa and ıntrauterıne growth retardatıon
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Objective: To estimate the relationship between maternal serum a- fetoprotein (MSAFP) levels and uterine artery Doppler findings at 20th week of pregnancy for prediction of preeclampsia and intrauterine growth retardation (IUGR). Methods: Eighty pregnant women were followed as a study group prospectively. MSAFP levels at the 15-18th week of gestation and bilateral uterine artery Doppler findings at the 20th week of gestation were obtained. Results: Bilateral early diastolic notch of the uterine artery was detected in 17 cases (21,75%) at the 20th week of gestation. In 9 of them early diastolic notch was persistent at the 24th week while in 8 cases, it had disappeared. Uterine artery diastolic notch was found to be a significant predictive factor for preeclampsia, as well as for IUGR (p< 0.001, OR: 69.74; p<0.02, OR: 10.11, respectively). MSAFP levels of 17 cases that showed early diastolic notch in uterine artery Doppler were significantly higher than in the notch negative cases (p<0.05). The levels of MSAFP in 9 cases which demonstrated the persistence of diastolic notch, were significantly higher than the 8 cases where the notch had disappeared, at the 24th week of gestation (p<0.05). Conclusion: Our findings suggest that abnormal uterine artery Doppler findings at 20th week of gestation correlate with elevated MSAFP levels, and bilateral diastolic notch in uterine artery at 20 weeks’ gestation together with elevated MSAFP, is associated with poor obstetric outcome.