importance of maternal ischemia modified albumin, non stress test and doppler ultrasonography in foreseeing perinatal asphyxia

Ferruh Acet, V. Emirdar, M. Celiloğlu, M. Akış, G. İşlekel
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Abstract

Background: The aim of this study is to evaluate the importance of ischemia changed albumin, in foreseeing fetal asphyxia and comparing it between normal and preeclamptic pregnant. Method: We planned our study as a prospective case-controlled study between May 2011 and June 2013. We recruited 104 pregnant women complicated by preeclampsia and 110 healthy pregnant women in the study. Doppler ultrasonography, non-stress test and fetal biometric measurements were performed. Venous blood samples taken to measure ischemia modified albumin (IMA). The presence of fetal hypoxia/acidosis was analyzed by conducting post-natal cord blood gas examination and 1.-5. minutes APGAR scoring. Results: Women with preeclampsia had higher IMA compared to controls. The correlations between umbilical artery doppler systolic/diastolic (S/D) ratio, brain sparing effect, non stress test and IMA analyzed. We have found IMA statistically high when S/D ratio is above 2 standard deviations (preeclampsia; 11.83±1.33 vs 19.62±1.56 p<0.001, control; 10.28±1.57 vs 18.09±2.13 p<0.001) or brain sparing effect started (preeclampsia; 25.59±2.48 vs 9.16±1.99 p<0.001, control; 16.37±1.97 vs 6.72± 1.53 p<0.001) or abnormal NST findings occurred (preeclampsia; 10.69±1.92 vs 20.72±1.15 p<0.001, control; 7,42±1,94 vs 9,72±2,19 p<0.001). Conclusions: Maternal IMA levels are found high in preeclamptic pregnant women and it can be used as a biomarker for determining fetal wellbeing.
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母体缺血修饰白蛋白、非应激试验和多普勒超声在预测围产期窒息中的重要性
背景:本研究的目的是评价缺血改变白蛋白在预测胎儿窒息中的重要性,并比较正常妊娠和子痫前期妊娠的差异。方法:我们计划在2011年5月至2013年6月期间进行前瞻性病例对照研究。我们在研究中招募了104名合并先兆子痫的孕妇和110名健康孕妇。进行多普勒超声检查、非应激试验和胎儿生物特征测量。静脉血样本测量缺血修饰白蛋白(IMA)。通过产后脐带血气检查及1 -5分析胎儿缺氧/酸中毒的存在。分钟APGAR得分。结果:与对照组相比,子痫前期妇女的IMA较高。分析脐动脉多普勒收缩压/舒张压(S/D)比、脑保留效果、非应激试验与IMA的相关性。我们发现当S/D比值大于2个标准差时IMA在统计学上较高(先兆子痫;11.83±1.33 vs 19.62±1.56 p<0.001,对照组;10.28±1.57 vs 18.09±2.13 p<0.001)或脑保留效应开始(子痫前期;25.59±2.48 vs 9.16±1.99 p<0.001,对照组;16.37±1.97 vs 6.72±1.53 p<0.001)或出现异常的NST表现(先兆子痫;10.69±1.92 vs 20.72±1.15 p<0.001,对照组;7,42±1,94 vs 9,72±2,19 p<0.001)。结论:子痫前期孕妇的母体IMA水平较高,可作为胎儿健康的生物标志物。
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