placental size and uterine artery doppler for prediction of adverse pregnancy outcomes in women with low pregnancy-associated plasma protein-a

Background: patients with a low level of pregnancy-associated plasma protein-a (papp-a) experience more placental disorders in the second trimester. objectives: we aimed to assess uta-doppler and placental size to predict adverse pregnancy outcomes in a woman with placental insufficiency and low papp-a. methods: following a cross-sectional design, 83 singleton pregnant women with normal chromosomes and papp-a ≤ 0.5 were examined at 11 - 13 + 6 weeks of gestation. all participants with papp-a ≤ 0.5 were tested in the nilo laboratory of tehran from 2018 to 2019. the placental size and doppler uterine artery were assessed at 18 - 20 weeks. three cases were excluded due to abortion and aneuploidy. all participants were assigned to placenta lengths of < 10 cm and > 10 cm. all comparisons between two groups were assayed by the independent t-test, mann-whitney u test, χ^2-test or fisher exact test, and logistic regression model. results: of 80 women, 48 (60%) had placenta length of < 10 cm and 32(40%) had placenta length of > 10 cm. fourteen (17.5%) were preterm (< 32 weeks), and 36(45%) were iugr. according to the logistic regression model, in participants with a placenta length of < 10 cm, the risk of iugr was higher by 9-time than those with placenta length of > 10 cm (or = 9, ci95% = 3.20 - 25.29). also, the risk of preterm labor was 3.47 fold higher in the group with placenta length of < 10 cm, or: 3.47;( ci95% = 1.27 - 9.44). sensitivity of placenta length of < 10 cm for predicting iugr was 75% (ci95% = 56.60 - 88.54). conclusions: placental length measurement in the second trimester can help predict adverse pregnancy outcomes in pregnant women with low papp-a. placenta evaluation can assist in planning future pregnancy care to detect the pathology of fetal growth restriction.