The Relationship of Low PAPP A in the First Trimester of Pregnancy with Biometric Indicators and Resistance and Pulsation Indicators of Fetal Umbilical and Middle Cerebral Arteries and Uterine Arteries in the Third Trimester of Pregnancy

Abstract

Background: The purpose of this research was to determine the predictability of low values of “Pregnancy Associated Plasma Protein A” (PAPP A) in the first trimester of pregnancy in biometric indicators, as well as the resistance and pulsatility Indices of the umbilical arteries, fetal middle brain, and uterine arteries in Doppler ultrasound in the third trimester of pregnancy. Methods: In a cohort study during 2020-2022, a number of 120 pregnant women who had PAPP A ≤ 0.4 in the first trimester of pregnancy were included in the study and then underwent biometric sonography assessment at the 28th to 32nd week of pregnancy. Also, Doppler sonography was performed simultaneously. The study measured the relationship between clinical signs, Doppler sonographic indices, biometry, and PAPP A ≥ 0.4 and the potential to predict these indicators in the occurrence of fetuses with growth restriction. Findings: No statistically significant relationship between PAPP A≤0.4 and SGA and FGR was observed. However, components such as the S/D Ratio and AC revealed a predictive role in the occurrence of SGA, and components such as pregnancy age, AC, and HC showed a significant predictive role in the occurrence of FGR. Conclusion: In pregnant women with PAPP A values ≤0.4 in the first trimester, the occurrence of SGA can be predicted based on the following components: fetal abdominal circumference and systolic to diastolic ratio. Factors such as gestational age, fetal abdominal circumference, and fetal head circumference significantly played a role in predicting the occurrence of FGR. © 2024 Isfahan University of Medical Sciences(IUMS). All rights reserved.