{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:24:21Z","timestamp":1781652261048,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,4,28]],"date-time":"2009-04-28T00:00:00Z","timestamp":1240876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Low maternal serum levels of pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A) are associated with both increased risk of aneuploidies and impaired trophoblastic invasion, while high uterine artery (UtA) resistance is associated with impaired trophoblastic invasion but not with an increased risk of aneuploidies. The aim of this study was to determine whether high UtA resistance plays a role in explaining low PAPP\u2010A levels in the absence of aneuploidies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective study of 116 singleton pregnancies at high risk for impaired placentation (having at least one major risk factor: prior history of pre\u2010eclampsia, pregestational diabetes mellitus, chronic hypertension, chronic kidney disease, body mass index &gt;30, autoimmune disorder, thrombophilia or recurrent pregnancy loss), booked for routine assessment of risk for aneuploidies by means of the first\u2010trimester combined screening test (nuchal translucency thickness (NT) + PAPP\u2010A + beta\u2010human chorionic gonadotropin (\u03b2\u2010hCG)). Measurement of NT and the mean UtA pulsatility index (PI) were carried out at the 11 to 13 + 6\u2010week scan. All values were calculated in multiples of the median (MoM) adjusted for gestational age. A cut\u2010off risk of 1\/270 at time of sampling was adopted to differentiate high\u2010 from low\u2010risk groups for trisomy 21.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 108 patients deemed to be at low risk for trisomy 21 and eight at high risk. None had chromosomal defects, giving a false\u2010positive rate for trisomy 21 of 6.9%. The greatest differences between patients at low risk and those at high risk for trisomy 21 were found in their PAPP\u2010A (0.98 vs. 0.38 MoM, <jats:italic>P<\/jats:italic> &lt; 0.01) and \u03b2\u2010hCG (1.09 vs. 1.77 MoM, <jats:italic>P<\/jats:italic> = 0.04) values. Greater NT thickness (1.02 vs. 0.90 MoM) and higher mean UtA\u2010PI (1.05 vs. 0.96 MoM) were recorded in the high\u2010risk group, although the differences did not reach statistical significance (<jats:italic>P<\/jats:italic> = 0.19 and 0.40, respectively). After log\u2010transformation there were no significant correlations between mean UtA\u2010PI and NT and between mean UtA\u2010PI and \u03b2\u2010hCG. There was a significant negative linear correlation between mean UtA\u2010PI and PAPP\u2010A (<jats:italic>r<\/jats:italic> = \u22120.331; <jats:italic>P<\/jats:italic> &lt; 0.01). After adjusting the PAPP\u2010A values by UtA\u2010PI, the false\u2010positive rate for trisomy 21 decreased to 2.6%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Mean UtA\u2010PI at the 11 to 13 + 6\u2010week scan may be an effect\u2010modifier variable for PAPP\u2010A that should be taken into account in the first\u2010trimester combined screening for aneuploidies, at least in pregnancies at high risk for impaired placentation. Copyright \u00a9 2009 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.6366","type":"journal-article","created":{"date-parts":[[2009,4,28]],"date-time":"2009-04-28T13:42:47Z","timestamp":1240926167000},"page":"518-523","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Role of uterine artery Doppler in interpreting low PAPP\u2010A values in first\u2010trimester screening for Down syndrome in pregnancies at high risk of impaired placentation"],"prefix":"10.1002","volume":"33","author":[{"given":"I.","family":"Herraiz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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P.","family":"Villar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Escribano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Galindo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,4,28]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1993.tb12973.x"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1999.13040231.x"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.128"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1860"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1203"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5334"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1540"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11618.x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.06.052"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1251"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3809"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5165"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5163"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1890"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2004.02.003"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.0960-7692.2001.00585.x"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2676"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5157"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5402"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.3109\/10641950109152635"},{"key":"e_1_2_6_22_2","unstructured":"SantamariaR Verd\u00faLI Mart\u00ednC Garc\u00edaG. Tablas espa\u00f1olas de pesos neonatales seg\u00fan edad gestacional.Sociedad Espa\u00f1ola de Ginecologia y Obstetricia1998; Available from:http:\/\/www.mashierro.com\/pages\/pesos_neonatales.php."},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3881"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.01.063"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.6366","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.6366","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T02:06:25Z","timestamp":1695953185000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.6366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,4,28]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2009,5]]}},"alternative-id":["10.1002\/uog.6366"],"URL":"https:\/\/doi.org\/10.1002\/uog.6366","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,4,28]]},"assertion":[{"value":"2009-02-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-04-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}