The importance of maternal ischemia modified albümin , non stres test and doppler ultrasonography in foreseeing perinatal asphyxia

The importance of maternal ischemia modified albümin , non stres test and doppler ultrasonography in foreseeing perinatal asphyxia Objective : The aim of this study is the place of ischemia modified albumin , fetal doppler ultrasonograhpy and non stress test , in foreseeing fetal asphyxia and comparing it between normal and preeclampsia pregnants. Method: Our study is conducted in 9 Eylül University between May 2011 and September 2013 as prospective case-control study after the approval of local ethic committee. 110 healty pregnant and 104 preeclamptic pregnants recruited in the study. The pregnants in the study were between 32 to 42 gestational weeks , single and with normal fetal anatomy. Before birth, doppler ultrasonography and fetal biometric measuring performed to all pregnants between 34 to 42 gestational weeks who has been referred to our clinic for normal vaginal birth and c- sections ( emergent and planned ) . 2 SD< decrease in MCA PI and 2 SD< increase in umblical artery S/D ratio is accepted as abnormal doppler finding.Besides it has been accepted as brain sparing effect when the umblical artery PI / MCA PI ratio is above 1,08. Approximately 5ml of venous blood is taken into non-heparinised tubes and centrifuged ,from all patients added to study to measure ischemia modified albumin.Samples are kept in ? 80 C degrees after centrifuge. Findings: When examining the average of the maternal blood ischemia albumin levels in healty and preeclamptic pregnants added to study , in preeclamptic group IMA levels are found statistically high (p<0,0001) . The relation between umblical artery doppler S/D ratio , brain sparing effect , NST abnormalitiy and IMA analised . In both groups , IMA has been found statistically high when S/D ratio is above 2 standard deviation , brain sparing effect started , abnormal NST findings happened. (p<0,0001) When APGAR score and cord blood gas is examined for fetal well being evaluation , IMA levels has been found statistically high when APGAR score is 6 and under and pH is under 7,5. (p<0,0001) . There is no significant difference found between birth way and IMA Result: Maternal IMA levels are found clearly high in preeclampsia pregnancies.Also in patients with abnormal doppler findings and abnormal NST findings , IMA leves are determined significantly high. Together with this in babies with hipoxia symptoms, maternal IMA levels found clearly high.As a result , if it?s been supported with contentful studies, IMA levels can light the way to the future for foreseeing preeclampsia and determining fetal well being. KEY WORDS: Preeclampsia , , ischemia modified albumin , fetal hipoxia , NST , Doppler ultrasonography