Iranian Society of Gynecology Oncology

Document Type : Original Research Article

Authors

1 Department of Obstetrics and Gynecology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

2 Department of Obstetrics and Gynecology, Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran

3 Department of Epidemiology and Biostatistics, School of Medicine, Urmia University of Medical Science, Urmia, Iran

Abstract

Background and Objective:  Preeclampsia is a disorder of pregnancy with increased maternal and perinatal morbidity and mortality. The detection of a short femur length, particularly below the 5th centile is often a diagnostic dilemma. It might be associated with fetal growth restriction at the time of the ultrasound examination The purpose of this study was to assess the contribution of short femur diaphysis length (FDL) at 32–37 weeks of gestation in preeclampsia.
Material and Methods: The study included pregnant women who underwent a routine anomaly scan at 32–37 weeks of gestation at the Shahid Motahari University Hospital (Iran, Urmia) between February 2021 and February 2022. Fetal biometry and Doppler ultrasound of uterine arteries were assessed as part of the anomaly scan, and the mean pulsatility index of both uterine arteries was recorded. Maternal obstetric characteristics, such as ethnicity, age, weight, parity, cigarette smoking, and medical history including hypertension and diabetes mellitus were collected from our database system.
Results: the results of the present study illustrated that multivariate analysis of fetal femoral length percentile was associated with maternal age, preeclampsia, and the number of previous pregnancies. Furthermore, the sensitivity and specificity of the 50th-percentile femoral in the diagnosis of preeclampsia were % 96.88 and %81.88  respectively.
Conclusions: our results suggest that Short FDL at 32–37 weeks of gestation is a significant relationship with PE.

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Main Subjects

1. Fondjo LA, Boamah VE, Fierti A, Gyesi D, Owiredu E-W. Knowledge of preeclampsia and its associated factors among pregnant women: a possible link to reduce related adverse outcomes. BMC Pregnancy Childbirth. 2019;19(1):1-7. [DOI:10.1186/s12884-019-2623-x] [PMID] [PMCID]
2. Keshavarz E, Sadeghian A, Ganjalikhan Hakemi A, Talei Khtibi F. Prediction of Pre-Eclampsia Development by Placenta Location: A Simple Predictor. J Obstet Gynaecol Cancer Res. 2022;2(4):1-5. [DOI:10.5812/jogcr.11945]
3. Fox R, Kitt J, Leeson P, Aye CYL, Lewandowski AJ. Preeclampsia: risk factors, diagnosis, management, and the cardiovascular impact on the offspring. J Clin Med. 2019;8(10):1625. [DOI:10.3390/jcm8101625] [PMID] [PMCID]
4. Rahayu KD, Sigit R, Agata D, Pambudi A, Istiqomah N, editors. Automatic Gestational Age Estimation by Femur Length Using Integral Projection from Fetal Ultrasonography. 2018 International Seminar on Application for Technology of Information and Communication; 2018.
5. Moawad EMI, Tammam ASF, Mosaad MM, Sayed HME, Atef A. Evaluating the predictive value of fetal Doppler indices and neonatal outcome in late-onset preeclampsia with severe features: a cross-sectional study in a resource-limited setting. BMC Pregnancy and Childbirth. 2022;22(1):377. [DOI:10.1186/s12884-022-04704-0] [PMID] [PMCID]
6. Ghulmiyyah L, Sibai B. Maternal Mortality From Preeclampsia/Eclampsia. Semin Perinatol. 2012;36(1):56-9. [DOI:10.1053/j.semperi.2011.09.011] [PMID]
7. Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2011;25(4):391-403. [DOI:10.1016/j.bpobgyn.2011.01.006] [PMID]
8. Huppertz B. Special Issue "Molecular and Cellular Mechanisms of Preeclampsia". 2020. p. 4801. [DOI:10.3390/ijms21134801] [PMID] [PMCID]
9. Weissgerber TL, Milic NM, Milin-Lazovic JS, Garovic VD. Impaired Flow-Mediated Dilation Before, During, and After Preeclampsia. Hypertension. 2016;67(2):415-23. [DOI:10.1161/HYPERTENSIONAHA.115.06554] [PMID] [PMCID]
10. D'Ambrosio V, Vena F, Marchetti C, Di Mascio D, Perrone S, Boccherini C, et al. Midtrimester isolated short femur and perinatal outcomes: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2019;98(1):11-7. [DOI:10.1111/aogs.13470] [PMID]
11. Ventura W, Huaman J, Nazario CE, Ingar J, Huertas E, Antonio Limay O. Perinatal outcomes after sonographic detection of isolated short femur in the second trimester. Clin Ultrasound. 2012;40(2):63-7. [DOI:10.1002/jcu.20889] [PMID]
12. Todros T, Massarenti I, Gaglioti P, Biolcati M, Botta G, De Felice C. Fetal short femur length in the second trimester and the outcome of pregnancy. BJOG. 2004;111(1):83-5. [DOI:10.1046/j.1471-0528.2003.00015.x] [PMID]
13. Friebe-Hoffmann U, Dobravsky L, Friedl TWP, Janni W, Knippel AJ, Siegmann HJ, Kozlowski P. The femur too short? 1373 fetuses with short femur during second-trimester screening. Arch Gynecol Obstet. 2022;306(4):1037-44. [DOI:10.1007/s00404-021-06394-z] [PMID] [PMCID]
14. Macdonald-Wallis C, Lawlor DA, Heron J, Fraser A, Nelson SM, Tilling K. Relationships of risk factors for pre-eclampsia with patterns of occurrence of isolated gestational proteinuria during normal term pregnancy. PLoS One. 2011;6(7):e22115. [DOI:10.1371/journal.pone.0022115] [PMID] [PMCID]
15. Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams's obstetrics. 23rd ed. New York: McGraw-Hill; 2010.
16. Bahadoran P, Zendehdel M, Movahedian A, Zahraee RH. The relationship between serum zinc level and preeclampsia. Iran J Nurs Midwifery Res. 2010;15(3):120-4.
17. Shahidifar s, Sharifnia H, Taghipoor B, Hekmat Afshar M, Motevalli R, khalili Y, Mazraie F. Association between seasonal patterns and preeclampsia. Iran J Obstet Gynecol Infertil. 2014;17(125):8-14.
18. Sheen J-J, Huang Y, Andrikopoulou M, Wright JD, Goffman D, D'Alton ME, Friedman AM. Maternal age and preeclampsia outcomes during delivery hospitalizations. Am J Perinatol. 2020;37(01):044-52. [DOI:10.1055/s-0039-1694794] [PMID]
19. Kashanian M, Mohammadi A, Baradaran HR. Evaluation of Some of the risk factors for preeclampsia. Razi J Med Sci. 2008;15:131-6.
20. Bromley B, Brown DL, Benacerraf BR. Short femur length associated with severe intrauterine growth retardation. Prenat Diagn. 1993;13(6):449-52. [DOI:10.1002/pd.1970130605] [PMID]
21. Mailath-Pokorny M, Polterauer S, Worda K, Springer S, Bettelheim D. Isolated short fetal femur length in the second trimester and the association with adverse perinatal outcome: experiences from a tertiary referral center. PLoS One. 2015;10(6):e0128820. [DOI:10.1371/journal.pone.0128820] [PMID] [PMCID]
22. Morales-Roselló J, Peralta Llorens N. Outcome of Fetuses with Diagnosis of Isolated Short Femur in the Second Half of Pregnancy. Obstet Gynecol. 2012;2012:268218. [DOI:10.5402/2012/268218] [PMID] [PMCID]