Impaired placental perfusion and major fetal cardiac defects

Journal article

Fantasia, I., Andrade, W., Syngelaki, A., Akolekar, R. and Nicolaides, K.H. 2019. Impaired placental perfusion and major fetal cardiac defects. Ultrasound in Obstetrics and Gynecology. 53 (1), pp. 68-72. https://doi.org/10.1002/uog.20149
AuthorsFantasia, I., Andrade, W., Syngelaki, A., Akolekar, R. and Nicolaides, K.H.
Abstract

Objectives: To investigate the relationship between fetal congenital heart defects (CHD) and placental perfusion assessed by uterine artery pulsatility index (UtA-PI) in relation to development of preeclampsia (PE).

Methods: This was a prospective screening study in singleton pregnancies at 19-24 weeks’ gestation. Transvaginal ultrasound was used to measure the UtA-PI and the values were converted into multiples of the normal median (MoM). Median MoM values in pregnancies with fetuses with isolated major CHD were compared to those without CHD in relation to development of PE.

Results: The 91,407 singleton pregnancies fulfilling the entry criteria included 206 (0.23%) with isolated major fetal CHD and 91,201 without CHD. The prevalence of PE was 4.4% in those with CHD and 2.7% in those without CHD (RR 1.6, 95% CI 0.84-3.04; p=0.150); the respective values for preterm-PE, with delivery at <37 weeks’ gestation, were 2.4% and 0.7%, (RR 3.4, 95% CI 1.42-8.09; p=0.006). In the total population, the median UtA-PI MoM was significantly higher in those that developed PE compared to those without PE (1.22, IQR 0.94-1.57 vs. 1.00, IQR 0.84-1.19; p<0.0001) and in the PE group the median UtA-PI MoM was inversely related to gestational age at delivery (r=-0.458; p<0.0001). The same pattern of inverse relationship between UtA-PI MoM and gestational age at delivery with PE was observed in pregnancies with and without CHD, but in the CHD group, compared to those without CHD, UtA-PI was significantly higher both in pregnancies with and in those without
PE.

Conclusions: In both pregnancies with and without fetal CHD that develop PE impedance to flow in the uterine arteries is increased and this increase is particularly marked in those with preterm-PE. The prevalence of preterm-PE is more than 3 times higher in pregnancies with than without fetal major CHD and the prevalence of major CHD in pregnancies with preterm-PE is also more than 3 times higher than in those without PE. However, >97% of pregnancies with fetal CHD do not develop preterm-PE and >99% of pregnancies with preterm-PE are not associated with fetal CHD.

KeywordsCongenital heart defect; Uterine artery pulsatility index; Pre-eclampsia; Ultrasound screening
Year2019
JournalUltrasound in Obstetrics and Gynecology
Journal citation53 (1), pp. 68-72
PublisherWiley
ISSN1469-0705
Digital Object Identifier (DOI)https://doi.org/10.1002/uog.20149
Official URLhttp://doi.iorg/10.1002/uog.20149
Publication dates
Online17 Oct 2018
Publication process dates
Accepted10 Oct 2018
Deposited03 Jun 2020
Accepted author manuscript
Output statusPublished
References

1. Akolekar R, Zaragoza E, Poon LC, Pepes S, Nicolaides KH. Maternal serumplacental growth factor at 11 + 0to13+ 6 weeks of gestation in the prediction ofpre-eclampsia. Ultrasound Obstet Gynecol 2008; 32: 732– 739.
2. O’Gorman N, Wright D, Syngelaki A, Akolekar R, Wright A, Poon LC, NicolaidesKH. Competing risks model in screening for preeclampsia by maternal factorsand biomarkers at 11-13 weeks’ gestation. Am J Obstet Gynecol 2016; 214:103.e1–12.
3. Tan MY, Syngelaki A, Poon LC, Rolnik DL, O’Gorman N, Delgado JL, Akolekar R,Konstantinidou L, Tsavdaridou M, Galeva S, Ajdacka U, Molina FS, Persico N, JaniJC, Plasencia W, Greco E, Papaioannou G, Wright A, Wright D, Nicolaides KH.Screening for pre-eclampsia by maternal factors and biomarkers at 11– 13 weeks’gestation. Ultrasound Obstet Gynecol 2018; 52: 186– 195.
4. Llurba E, Syngelaki A, Sanchez O, Carreras E, Cabero L, Nicolaides KH. Maternalserum placental growth factor at 11–13 weeks’ gestation and fetal cardiac defects.Ultrasound Obstet Gynecol 2013; 42: 169–174.
5. Fantasia I, Kasapoglu D, Kasapoglu T, Syngelaki A, Akolekar R, Nicolaides KH.Fetal major cardiac defects and placental dysfunction at 11–13 weeks’ gestation.Ultrasound Obstet Gynecol 2018; 51: 194–198.
6. Auger N, Fraser WD, Healy-Profit´os J, Arbour L. Association between preeclampsiaand congenital heart defects. JAMA 2015; 314: 1588–1598.
7. Brodwall K, Leirgul E, Greve G, Vollset SE, Holmstrøm H, Tell GS, Øyen N. Possiblecommon aetiology behind maternal preeclampsia and congenital heart defects in thechild: a Cardiovascular Diseases in Norway Project Study. Paediatr Perinat Epidemiol2016; 30: 76–85.
8. Boyd HA, Basit S, Behrens I, Leirgul E, Bundgaard H, Wohlfahrt J, Melbye M,Øyen N. Association between fetal congenital heart defects and maternal risk ofhypertensive disorders of pregnancy in the same pregnancy and across pregnancies.Circulation 2017; 136: 39–48.
9. Gallo DM, Wright D, Akolekar R, Poon LC, Nicolaides KH. Competing risks modelin screening for preeclampsia by maternal factors and biomarkers at 19-24 weeks’gestation. Am J Obstet Gynecol 2016; 214: 619.e1–17.
10. Litwinska M, Wright D, Efeturk T, Ceccacci I, Nicolaides KH. Proposed clinicalmanagement of pregnancies after combined screening for pre-eclampsia at 19–24weeks’ gestation. Ultrasound Obstet Gynecol 2017; 50: 367– 372.
11. Litwinska M, Syngelaki A, Wright A, Wright D, Nicolaides KH. Management ofpregnancies after combined screening for pre-eclampsia at 19–24 weeks’ gestation.Ultrasound Obstet Gynecol 2018; 52: 365–372.
12. Papageorghiou AT, Yu CKH, Bindra R, Pandis G and Nicolaides KN. Multicentrescreening for pre-eclampsia and fetal growth restriction by transvaginal uterineartery Doppler at 23 weeks of gestation. Ultrasound Obstet Gynecol 2001; 18:441–449.
13. Robinson HP, Fleming JE. A critical evaluation of sonar crown rump lengthmeasurements. BrJObstetGynaecol1975; 82: 702–710.
14. Snijders RJ, Nicolaides KH. Fetal biometry at 14–40 weeks’ gestation. UltrasoundObstet Gynecol 1994; 4: 34– 38.
15. Brown MA, Lindheimer MD, de Swiet M, Van Assche A, Moutquin JM. Theclassification and diagnosis of the hypertensive disorders of pregnancy: Statementfrom the international society for the study of hypertension in pregnancy (ISSHP).Hypertens Pregnancy 2001; 20:IX–XIV.
16. Tayyar A, Guerra L, Wright A, Wright D, Nicolaides KH. Uterine artery pulsatilityindex in the three trimesters of pregnancy: effects of maternal characteristics andmedical history. Ultrasound Obstet Gynecol 2015; 45: 689– 697.
17. Plasencia W, Maiz N, Poon L, Yu C, Nicolaides KH. Uterine artery Doppler at 11 +0to13+ 6 weeks and 21 + 0to24+ 6 weeks in the prediction of pre-eclampsia.Ultrasound Obstet Gynecol 2008; 32: 138– 146.
18. Tsiakkas A, Saiid Y, Wright A, Wright D, Nicolaides KH. Competing risks modelin screening for preeclampsia by maternal factors and biomarkers at 30-34 weeks’gestation. Am J Obstet Gynecol 2016; 215: 87.e1– 17.
19. Albaiges G, Missfelder-Lobos H, Lees C, Parra M, Nicolaides KH. One-stagescreening for pregnancy complications by color doppler assessment of the uterinearteries at 23 weeks’ gestation. Obstet Gynecol 2000; 96: 559–564.
20. Yu CK, Smith GC, Papageorghiou AT, Cacho AM, Nicolaides KH. An integratedmodel for the prediction of preeclampsia using maternal factors and uterine arteryDoppler velocimetry in unselected low-risk women. Am J Obstet Gynecol 2005; 193:429–436.
21. Gallo DM, Poon LC, Akolekar R, Syngelaki A, Nicolaides KH. Prediction ofpreeclampsia by uterine artery Doppler at 20-24 weeks’ gestation. Fetal Diagn Ther2013; 34: 241–247.
22. Lai J, Poon LC, Pinas A, Bakalis S, Nicolaides KH. Uterine artery Doppler at 30-33weeks’ gestation in the prediction of preeclampsia. Fetal Diagn Ther 2013; 33:156–163.
23. Tayyar A, Garcia-Tizon Larroca S, Poon LC, Wright D, Nicolaides KH. Competingrisk model in screening for preeclampsia by mean arterial pressure and uterine arterypulsatility index at 30-33 weeks’ gestation. Fetal Diagn Ther 2014; 36: 18–27.
24. Brosens I, Robertson WB, Dixon HG. The physiological response of the vessels ofthe placental bed to normal pregnancy. J Pathol Bacteriol 1967; 93: 569– 579.
25. Khong TY, De Wolf F, Robertson WB, Brosens I. Inadequate maternal vascularresponse to placentation in pregnancies complicated by pre-eclampsia and bysmall-for gestational age infants. BrJObstetGynaecol1986; 93: 1049–1059.
26. Pijnenborg R. The placental bed. Hypertens Pregnancy 1996; 15: 7– 23.
27. Linask KK. The heart-placenta axis in the first month of pregnancy: induction andprevention of cardiovascular birth defects. J Pregnancy 2013: 2013: 320413.
28. Maslen CL. Recent Advances in Placenta-Heart Interactions. Front Physiol 2018; 9 :735.
29. Llurba E, S´anchez O, Ferrer Q, Nicolaides KH, Ru´ız A, Dom´ınguez C,S´anchez-de-Toledo J, Garc´ıa-Garc´ıa B, Soro G, Ar´evaloS,GoyaM,SuyA,P´erez-Hoyos S, Alijotas-Reig J, Carreras E, Cabero L. Maternal and foetal angiogenicimbalance in congenital heart defects. Eur Heart J 2014; 35: 701–707.
30. Wright D, Syngelaki A, Akolekar R, Poon LC, Nicolaides KH. Competing risksmodel in screening for preeclampsia by maternal characteristics and medical history.Am J Obstet Gynecol 2015; 213: 62.e1–10.
31. Rolnik DL, Wright D, Poon LC, O’Gorman N, Syngelaki A, de Paco Matallana C,Akolekar R, Cicero S, Janga D, Singh M, Molina FS, Persico N, Jani JC, Plasencia W,Papaioannou G, Tenenbaum-Gavish K, Meiri H, Gizurarson S, Maclagan K,Nicolaides KH. Aspirin versus placebo in pregnancies at high risk for pretermpreeclampsia. NEnglJMed2017; 377: 613–622.

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Elger, T., Akolekar, R., Syngelaki, A., De Paco Matallana, C., Molina, F. S., Gallardo Arozena, M., Chaveeva, P., Persico, N., Accurti, V., Kagan, O., Prodan, N., Cruz, J. and Nicolaides, K. H. 2021. Fetal loss after chorionic villus sampling in twin pregnancies. Ultrasound in Obstetrics & Gynecology. 58 (1), pp. 48-55. https://doi.org/10.1002/uog.23694
Kielland’s rotational forceps delivery: comparison of maternal and neonatal outcomes with pregnancies delivering by non-rotational forceps
Giacchino, Tara, Karkia, Rebecca, Zhang, Weiyu, Ahmed, Hasib and Akolekar, Ranjit 2021. Kielland’s rotational forceps delivery: comparison of maternal and neonatal outcomes with pregnancies delivering by non-rotational forceps. Journal of Obstetrics and Gynaecology. 42 (3), pp. 379-384. https://doi.org/10.1080/01443615.2021.1907557
Reference ranges for the pulsed wave doppler of the fetal cardiac inflow and outflow tracts from 13 to 36 weeks gestation: Short title: Zidere, Fetal inflow and outflow tract, Pulsed wave Doppler, z scores.
Zidere, V., Vigneswaran, T. V., Syngelaki, A., Charakida, M., Allan, L. D., Nicolaides, K. H., Simpson, J. M and Akolekar, R. 2021. Reference ranges for the pulsed wave doppler of the fetal cardiac inflow and outflow tracts from 13 to 36 weeks gestation: Short title: Zidere, Fetal inflow and outflow tract, Pulsed wave Doppler, z scores. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. https://doi.org/S0894-7317(21)00467-3
Value of routine ultrasound examination at 35-37 weeks' gestation in diagnosis of fetal abnormalities
Ficara, A., Syngelaki, A., Hammami, A., Akolekar, R. and Nicolaides, K. H. 2020. Value of routine ultrasound examination at 35-37 weeks' gestation in diagnosis of fetal abnormalities. Ultrasound in Obstetrics and Gynecology. 55 (1), pp. 75-80. https://doi.org/10.1002/uog.20857
Diagnosis of fetal defects in twin pregnancies at routine 11-13-week ultrasound examination
Syngelaki, A., Cimpoca, B., Litwinska, E., Akolekar, R. and Nicolaides, K. H. 2020. Diagnosis of fetal defects in twin pregnancies at routine 11-13-week ultrasound examination. Ultrasound in Obstetrics and Gynecology. 55 (4), pp. 474-481. https://doi.org/10.1002/uog.21938
Metformin use in obese mothers is associated with improved cardiovascular profile in the offspring
Panagiotopoulou, O., Syngelaki, A., Georgiopoulos, G., Simpson, J., Akolekar, R., Shehata, H., Nicolaides, K. H. and Charakida, M. 2020. Metformin use in obese mothers is associated with improved cardiovascular profile in the offspring. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2020.01.054
ISUOG Consensus Statement on organization of routine and specialist obstetric ultrasound services in the context of COVID-19
Abu-Rustum, R. S., Akolekar, R., Sotiriadis, A., Salomon, L. J., Da Silva Costa, F., Wu, Q., Frusca, T., Bilardo, C. M., Prefumo, F. and Poon, L. C. 2020. ISUOG Consensus Statement on organization of routine and specialist obstetric ultrasound services in the context of COVID-19. Ultrasound in Obstetrics and Gynecology. https://doi.org/10.1002/uog.22029
Comparison of different methods of measuring angle of progression in prediction of labor outcome
Frick, A., Kostiv, V., Vojtassakova, D., Akolekar, R. and Nicolaides, K. H. 2020. Comparison of different methods of measuring angle of progression in prediction of labor outcome. Ultrasound in Obstetrics & Gynecology. 55 (3), pp. 391-400. https://doi.org/10.1002/uog.21913
Value of routine ultrasound examination at 35–37 weeks' gestation in diagnosis of non‐cephalic presentation
De Castro, H., Ciobanu, A., Formuso, C., Akolekar, R. and Nicolaides, K. H. 2020. Value of routine ultrasound examination at 35–37 weeks' gestation in diagnosis of non‐cephalic presentation. Ultrasound in Obstetrics & Gynecology. 55 (2), pp. 248-256. https://doi.org/10.1002/uog.21902
Routine first-trimester screening for fetal trisomies in twin pregnancy: cell-free DNA test contingent on results from combined test
Galeva, S., Konstantinidou, L., Gil, M.M., Akolekar, R. and Nicolaides, K.H. 2019. Routine first-trimester screening for fetal trisomies in twin pregnancy: cell-free DNA test contingent on results from combined test. Ultrasound in Obstetrics and Gynecology. 53 (2), pp. 208-213. https://doi.org/10.1002/uog.20160
Fetal Medicine Foundation reference ranges for umbilical artery and middle cerebral artery pulsatility index and cerebroplacental ratio
Ciobanu, A., Wright, A., Syngelaki, A., Wright, D., Akolekar, R. and Nicolaides, K.H. 2019. Fetal Medicine Foundation reference ranges for umbilical artery and middle cerebral artery pulsatility index and cerebroplacental ratio. Ultrasound in Obstetrics and Gynecology. 53 (4), pp. 465-472. https://doi.org/10.1002/uog.20157
Prediction of adverse perinatal outcome by cerebroplacental ratio in women undergoing induction of labor
Fiolna, M., Kostiv, V., Anthoulakis, C., Akolekar, R. and Nicolaides, K.H. 2019. Prediction of adverse perinatal outcome by cerebroplacental ratio in women undergoing induction of labor. Ultrasound in Obstetrics and Gynecology. 53 (4), pp. 473-480. https://doi.org/10.1002/uog.20173
Prediction of small for gestational age neonates: screening by maternal factors, fetal biometry, and biomarkers at 35-37 weeks' gestation
Ciobanu, A., Rouvali, A., Syngelaki, A., Akolekar, R. and Nicolaides, K.H. 2019. Prediction of small for gestational age neonates: screening by maternal factors, fetal biometry, and biomarkers at 35-37 weeks' gestation. American Journal of Obstetrics & Gynecology. 220 (5), pp. 486.e1-486.e11. https://doi.org/10.1016/j.ajog.2019.01.227
Prediction of small-for-gestational-age neonates at 35-37 weeks' gestation: contribution of maternal factors and growth velocity between 20 and 36 weeks
Ciobanu, A., Formuso, C., Syngelaki, A., Akolekar, R. and Nicolaides, K.H. 2019. Prediction of small-for-gestational-age neonates at 35-37 weeks' gestation: contribution of maternal factors and growth velocity between 20 and 36 weeks. Ultrasound in Obstetrics and Gynecology. 53 (4), pp. 488-495. https://doi.org/10.1002/uog.20243
Routine assessment of cerebroplacental ratio at 35-37 weeks' gestation in the prediction of adverse perinatal outcome
Akolekar, R., Ciobanu, A., Zingler, E., Syngelaki, A. and Nicolaides, K.H. 2019. Routine assessment of cerebroplacental ratio at 35-37 weeks' gestation in the prediction of adverse perinatal outcome. American Journal of Obstetrics & Gynecology. 221 (1), pp. 65.e1-65.e18. https://doi.org/10.1016/j.ajog.2019.03.002
Routine ultrasound at 32 vs 36 weeks' gestation: prediction of small-for-gestational-age neonates
Ciobanu, A., Khan, N., Syngelaki, A., Akolekar, R. and Nicolaides, K. H. 2019. Routine ultrasound at 32 vs 36 weeks' gestation: prediction of small-for-gestational-age neonates. Ultrasound in Obstetrics and Gynecology. 53 (6), pp. 761-768. https://doi.org/10.1002/uog.20258
Prediction of small-for-gestational-age neonates at 35-37 weeks' gestation: contribution of maternal factors and growth velocity between 32 and 36 weeks
Ciobanu, A., Anthoulakis, C., Syngelaki, A., Akolekar, R. and Nicolaides, K.H. 2019. Prediction of small-for-gestational-age neonates at 35-37 weeks' gestation: contribution of maternal factors and growth velocity between 32 and 36 weeks. Ultrasound in Obstetrics and Gynecology. 53 (5), pp. 630-637. https://doi.org/10.1002/uog.20267
Maternal and neonatal complications of fetal macrosomia: cohort study
Beta, J., Khan, N., Fiolna, M., Khalil, A., Ramadan, G. and Akolekar, R. 2019. Maternal and neonatal complications of fetal macrosomia: cohort study. Ultrasound in Obstetrics and Gynecology. 54 (3), pp. 319-325. https://doi.org/10.1002/uog.20279
Procedure-related risk of miscarriage following chorionic villus sampling and amniocentesis
Beta, J., Zhang, W., Geris, S., Kostiv, V. and Akolekar, R. 2019. Procedure-related risk of miscarriage following chorionic villus sampling and amniocentesis. Ultrasound in Obstetrics and Gynecology. 54 (4), pp. 452-457. https://doi.org/10.1002/uog.20293
Biomarkers of impaired placentation at 35-37 weeks' gestation in the prediction of adverse perinatal outcome
Ciobanou, A., Jabak, S., De Castro, H., Frei, L., Akolekar, R. and Nicolaides, K. H. 2019. Biomarkers of impaired placentation at 35-37 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound in Obstetrics and Gynecology. 54 (1), pp. 79-86. https://doi.org/10.1002/uog.20346
Risk of miscarriage following amniocentesis or chorionic villus sampling: systematic review of literature and updated meta-analysis
Salomon, L. J., Sotiriadis, A., Wulff, C. B., Odibo, A. and Akolekar, R. 2019. Risk of miscarriage following amniocentesis or chorionic villus sampling: systematic review of literature and updated meta-analysis. Ultrasound in Obstetrics and Gynecology. 54 (4), pp. 442-451. https://doi.org/10.1002/uog.20353
Prediction of large-for-gestational-age neonate by routine third-trimester ultrasound
Khan, N., Ciobanu, A., Karampitsakos, T., Akolekar, R. and Nicolaides, K. H. 2019. Prediction of large-for-gestational-age neonate by routine third-trimester ultrasound. Ultrasound in Obstetrics and Gynecology. 54 (2), pp. 326-333. https://doi.org/10.1002/uog.20377
Two-stage approach for prediction of small-for-gestational-age neonate and adverse perinatal outcome by routine ultrasound examination at 35-37 weeks' gestation
Akolekar, R., Panaitescu, A. M., Ciobanu, A., Syngelaki, A. and Nicolaides, K. H. 2019. Two-stage approach for prediction of small-for-gestational-age neonate and adverse perinatal outcome by routine ultrasound examination at 35-37 weeks' gestation. Ultrasound in Obstetrics and Gynecology. 54, pp. 484-491. https://doi.org/10.1002/uog.20391
Prevention of stillbirths: impact of a two-stage screening for vasa previa
Zhang, W., Geris, S., Beta, J., Ramadan, G., Nicolaides, K. H. and Akolekar, R. 2019. Prevention of stillbirths: impact of a two-stage screening for vasa previa. Ultrasound in Obstetrics and Gynecology. 55 (5), pp. 605-612. https://doi.org/10.1002/uog.21953
Impact of prospective measurement of outflow tracts in the prediction of coarctation of the aorta
Vigneswaran, T. V., Zidere, V., Chivers, S., Charakida, M., Akolekar, R. and Simpson, J. M. 2019. Impact of prospective measurement of outflow tracts in the prediction of coarctation of the aorta. Ultrasound in Obstetrics and Gynecology. https://doi.org/10.1002/uog.21957
Diagnosis of major heart defects by routine first-trimester ultrasound examination: association with high nuchal translucency, tricuspid regurgitation and abnormal flow in the ductus venosus
Minnella, G. P., Crupano, F. M., Syngelaki, A., Zidere, V., Akolekar, R. and Nicolaides, K. H. 2019. Diagnosis of major heart defects by routine first-trimester ultrasound examination: association with high nuchal translucency, tricuspid regurgitation and abnormal flow in the ductus venosus. Ultrasound in Obstetrics and Gynecology. 55 (5), pp. 637-644. https://doi.org/10.1002/uog.21956
Screening for pre-eclampsia using sFlt-1/PlGF ratio cut-off of 38 at 30-37 weeks' gestation
Dragan, I., Georgiou, T., Prodan, N., Akolekar, R. and Nicolaides, K. H. 2017. Screening for pre-eclampsia using sFlt-1/PlGF ratio cut-off of 38 at 30-37 weeks' gestation. Ultrasound in Obstetrics and Gynecology. 49 (1), pp. 73-77. https://doi.org/10.1002/uog.17301
Uterine artery pulsatility index at 30-34 weeks' gestation in the prediction of adverse perinatal outcome
Valiño, N., Giunta, G., Gallo, D. M., Akolekar, R. and Nicolaides, K. H. 2016. Uterine artery pulsatility index at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound in Obstetrics and Gynecology. 47 (3), pp. 308-315. https://doi.org/10.1002/uog.14898
Biophysical and biochemical markers at 30-34 weeks' gestation in the prediction of adverse perinatal outcome
Valiño, N., Giunta, G., Gallo, D. M., Akolekar, R. and Nicolaides, K. H. 2016. Biophysical and biochemical markers at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound in Obstetrics and Gynecology. 47 (2), pp. 194-202. https://doi.org/10.1002/uog.14928
Screening for trisomies by cell-free DNA testing of maternal blood: consequences of a failed result
Revello, R., Sarno, L., Ispas, A., Akolekar, R. and Nicolaides, K. H. 2016. Screening for trisomies by cell-free DNA testing of maternal blood: consequences of a failed result. Ultrasound in Obstetrics and Gynecology. 47 (6), pp. 698-704. https://doi.org/10.1002/uog.15851
Metformin versus placebo in obese pregnant women without diabetes mellitus
Syngelaki, A., Nicolaides, K. H., Balani, J., Hyer, S., Akolekar, R., Kotecha, R., Pastides, A. and Shehata, H. 2016. Metformin versus placebo in obese pregnant women without diabetes mellitus. New England Journal of Medicine. 374, pp. 434-43. https://doi.org/10.1056/NEJMoa1509819
Prospective first-trimester screening for trisomies by cell-free DNA testing of maternal blood in twin pregnancy
Sarno, L., Revello, R., Hanson, E., Akolekar, R. and Nicolaides, K. H. 2016. Prospective first-trimester screening for trisomies by cell-free DNA testing of maternal blood in twin pregnancy. Ultrasound in Obstetrics and Gynecology. 47 (6), pp. 705-11. https://doi.org/10.1002/uog.15913
Prediction of stillbirth from biochemical and biophysical markers at 11-13 weeks
Mastrodima, S., Akolekar, R., Yerlikaya, G., Tzelepis, T. and Nicolaides, K. H. 2016. Prediction of stillbirth from biochemical and biophysical markers at 11-13 weeks. Ultrasound in Obstetrics and Gynecology. 48 (5), pp. 613-617. https://doi.org/10.1002/uog.17289
Prediction of stillbirth from maternal demographic and pregnancy characteristics
Yerlikaya, G., Akolekar, R., McPherson, K., Syngelaki, A. and Nicolaides, K. H. 2016. Prediction of stillbirth from maternal demographic and pregnancy characteristics. Ultrasound in Obstetrics and Gynecology. 48 (5), pp. 607-612. https://doi.org/10.1002/uog.17290
Endoscopic placental laser coagulation in dichorionic and monochorionic triplet pregnancies
Peeva, G., Chaveeva, P., Gil Guevara, E., Akolekar, R. and Nicolaides, K. H. 2016. Endoscopic placental laser coagulation in dichorionic and monochorionic triplet pregnancies. Fetal Diagnosis and Therapy. 40 (3), pp. 174-180. https://doi.org/10.1159/000443792
Prediction of stillbirth from maternal factors, fetal biometry and uterine artery Doppler at 19-24 weeks
Akolekar, R., Tokunaka, M., Ortega, N., Syngelaki, A. and Nicolaides, K. H. 2016. Prediction of stillbirth from maternal factors, fetal biometry and uterine artery Doppler at 19-24 weeks. Ultrasound in Obstetrics and Gynecology. 48 (5), pp. 624-630. https://doi.org/10.1002/uog.17295
Prediction of stillbirth from placental growth factor at 11-13 weeks
Akolekar, R., Machuca, M., Mendes, M., Paschos, V. and Nicolaides, K. H. 2016. Prediction of stillbirth from placental growth factor at 11-13 weeks. Ultrasound in Obstetrics and Gynecology. 48 (5), pp. 618-623. https://doi.org/10.1002/uog.17288
Prediction of stillbirth from placental growth factor at 19-24 weeks
Aupont J. E., Akolekar, R., Illian, A., Neonakis, S. and Nicolaides, K. H. 2016. Prediction of stillbirth from placental growth factor at 19-24 weeks. Ultrasound in Obstetrics and Gynecology. 48 (5), pp. 631-635. https://doi.org/10.1002/uog.17229
Biophysical and biochemical markers at 35-37 weeks' gestation in the prediction of adverse perinatal outcome
Valiño, N., Giunta, G., Gallo, D. M., Akolekar, R. and Nicolaides, K. H. 2015. Biophysical and biochemical markers at 35-37 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound in Obstetrics and Gynecology. 47 (2), pp. 203-209. https://doi.org/10.1002/uog.15663