Cell-free fetal DNA concentration in plasma of patients with abnormal uterine artery Doppler waveform and intrauterine growth restriction-a pilot study

• Published in: Prenatal diagnosis Vol. 23; no. 5; pp. 367 - 371
• Main Authors: Caramelli, Elisabetta, Rizzo, Nicola, Concu, Manuela, Simonazzi, Giuliana, Carinci, Paolo, Bondavalli, Corrado, Bovicelli, Luciano, Farina, Antonio
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-05-2003; Wiley
• Subjects: Adult; Arteries - diagnostic imaging; Biological and medical sciences; Case-Control Studies; cell-free fetal DNA; Chromosomes, Human, Y; Diseases of mother, fetus and pregnancy; DNA - blood; Female; Fetal Blood; Fetal Growth Retardation - blood; Fetal Growth Retardation - diagnostic imaging; Fetus - metabolism; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; intrauterine growth retardation; Male; Management. Prenatal diagnosis; Medical sciences; Pilot Projects; Pre-Eclampsia - blood; Pre-Eclampsia - diagnostic imaging; Pregnancy - blood; Pregnancy. Fetus. Placenta; Reverse Transcriptase Polymerase Chain Reaction; Sex Determination Analysis; Ultrasonography, Doppler; Ultrasonography, Prenatal; uterine artery Doppler screening; Uterus - blood supply; Uterus - diagnostic imaging; Sonography; Doppler ultrasound study; Waveform; Human; Intrauterine growth retardation; Pregnancy disorders; Growth; cell-free fetal DNA; Uterine artery; Blood plasma; Arterial disease; Prenatal; Fetal diseases; Mother; DNA; Fetus; Diagnosis; uterine artery Doppler screening
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.596

Objective
To evaluate if an increased amount of fetal DNA concentration can be found in women screened positive for intrauterine growth restriction because of abnormal uterine artery Doppler waveforms.
Methods
We enrolled eight pregnant women (each bearing a male fetus), with the evidence of abnormal uterine artery Doppler waveforms, and 16 control patients for a case‐control study matched for gestational age (1 : 2). Uterine artery Doppler was carried out at 20 to 35 weeks' gestation (median 29). The mean uterine artery resistance index (RI) was subsequently calculated, and a value >0.6 was considered positive for the clinical features of pre‐eclampsia. The SRY locus was used to determine the amount of male fetal DNA in the maternal plasma at the time of Doppler analysis.
Results
Two controls (normal Doppler) were excluded from the final analysis because they had a pre‐term delivery. One case (abnormal Doppler) had evidence of intrauterine growth restriction at the time of enrolment. In four out of eight cases (abnormal Doppler), intrauterine growth restriction was subsequently observed. Multiples of median (MoM) conversion of the fetal DNA values showed an increase of 1.81 times in the cases when compared to the controls. An increase of 2.16 times was instead observed for the cases with a growth‐restricted fetus (5 cases out of 8) in comparison with the controls (14 cases).
Conclusions
In subjects positive to uterine artery Doppler velocimetry analysis (Doppler analysis for pre‐eclampsia screening), the fetal DNA concentration is higher than expected, in the absence of any other clinical feature. Since the increase in fetal DNA seems to be related to the presence or to the future development of intrauterine growth restriction, this paper suggests a possible integration between ultrasound and molecular markers for predicting the disease in some cases. Copyright © 2003 John Wiley & Sons, Ltd.