ارزیابی نقش مارکرهای سرمی و سونوگرافی داپلر شریان رحمی در پیشگویی پره‌اکلامپسی در سه ماهه دوم بارداری: یک مطالعه مرور سیستماتیک

نوع مقاله : مروری

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 استادیار گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استادیار گروه زنان و مامایی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 دکتری بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: پره­اکلامپسی، شایع‌ترین عارضه طبی در بارداری است. با توجه به پاتوفیزیولوژی و اتیولوژی پیچیده پره‌اکلامپسی، طیف وسیعی از مارکرها بررسی شده‌اند که علاوه بر ارزش پیشگویی، شناسایی این عوامل ممکن است مکانیسم روشنی برای پاتوژنز پره­اکلامپسی فراهم کند. مطالعه مروری حاضر با هدف ارزیابی نقش چهار مارکر سرمی و سونوگرافی داپلر شریان رحمی در پیشگویی پره­اکلامپسی در سه ماهه دوم بارداری انجام شد.
روش‌کار: در این مطالعه مروری جهت یافتن مطالعات مرتبط، در بازه زمانی 2000 تا 2017 از پایگاه­های اطلاعاتی SID، Weily online library،Elsevier ، Scopus، Pubmed و همچنین موتور جستجوی Google Scholar استفاده شد. برای دستیابی به تمامی مقالات به زبان انگلیسی و فارسی مورد نظر از کلید واژه­های فارسی شامل: BHCG، اینهیبین A، اکتیوین A، آلفا فتوپروتئین، مارکرهای سرمی، سونوگرافی داپلر شریان رحمی، سه ماهه دوم و پیشگویی پره­اکلامپسی و کلید واژه­های انگلیسی شامل: serum markers،Uterine artery Doppler ultrasonography، Preeclampsia prediction، Second trimester، AFP، β-HCG، Activin A، Inhibin A با همه ترکیبات احتمالی این کلمات استفاده شد.
یافته‌ها: نتایج مطالعات مختلف بیانگر این مسئله بودند که هیچ یک مارکرهای مورد مطالعه شامل اکتیوین A و اینهیبین A، β-HCG و AFP به تنهایی قدرت پیشگویی پره­اکلامپسی را با حساسیت و ویژگی بالا فراهم نمی‌کنند، اما سونوگرافی داپلر شریان رحمی در سه ماهه دوم بارداری را می­توان به عنوان یک تست غربالگری برای پیشگویی پره­اکلامپسی در زنان پرخطر به‌کار برد.
نتیجه‌گیری: مهم‌ترین استراتژی‌های پیشگویی پره‌اکلامپسی شامل: مشخصات فردی، سونوگرافی شریان داپلر و بیومارکرها می­باشند و هیچ‌یک از این مارکرها به تنهایی قدرت پیشگویی پره­اکلامپسی را با حساسیت و ویژگی بالا فراهم نمی‌کنند.

کلیدواژه‌ها

عنوان مقاله [English]

Evaluation of the role of serum markers and Doppler ultrasonography of uterine artery in predicting preeclampsia at the second trimester of pregnancy: A systematic review

نویسندگان [English]

  • Maryam Tabatabaeian 1
  • Masoumeh Kordi 2
  • Salmeh Dadgar 3
  • Morvarid Irani 4
1 M.Sc. in Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant Professor, Department of Obstetrics and Gynecology, Women Health Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 PhD in Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

ntroduction: Preeclampsia is the most common medical complication in pregnancy. Regarding the pathophysiology and complex etiology of preeclampsia, a wide range of markers have been investigated. In addition to predictive value, identification of these factors may provide a clear mechanism for the pathogenesis of preeclampsia. This review study was performed with aim to evaluate the role of four serum markers and uterine artery Doppler ultrasonography in predicting preeclampsia at second trimester of pregnancy.
Methods: In this review study, the databases of SID, Weily online library, Elsevier, Scopus, Pubmed, and the Google Scholar search engine were used during 2000 to 2017 in order to find the relevant studies. To access all articles in English and Persian, the key words of BHCG, Inhibin A, Activin A, alpha-fetoprotein, serum markers, uterine artery Doppler sonography, second trimester, and preeclampsia prediction were used with all possible combinations of these words.
Results: The results of various studies indicate that none of the studied markers, including AFP, β-HCG, INH-A and Activin A alone, do not provide predictive power for preeclampsia with high sensitivity and specificity. However, uterine artery Doppler ultrasonography at second trimester of pregnancy can be used as a screening test to predict preeclampsia in high risk women.
Conclusion: The most important strategies for prediction of preeclampsia include individual characteristics, uterine artery ultrasonography, and biomarkers. None of these markers alone can't predict preeclampsia with high sensitivity and specificity.

کلیدواژه‌ها [English]

  • Serum markers
  • Doppler sonography
  • Preeclampsia
  • Second trimesterof pregnancy

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مجله زنان، مامایی و نازایی ایران
دوره 21، ویژه نامه
شهریور 1397
صفحه 76-85

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