The Effect of Aspirin in the Prevention of Preeclampsia in Women with Abnormal Uterine Artery Doppler Ultrasonography Findings

(1)

ƶºººƬŬƯ ƱŚºººŬƳŻƾĪºººƃżěƭƺºººƬƗƵŚĮºººƄƳřŵƾºººƄƷƹĦěƾºººưƬƗƽ ƹŵ ƵŹ ƽ ÏÒ ƵŹŚưƃ ƽ ÎÍÕ ŢƄƸŞƿŵŹřƹƲƿŵŹƹźƟ ÎÐÖÓ šŚŰƠƇ ÎÎ Śţ ÎÖ

ƾſŹźŝ

ţŚ

źǀŧ

ƲƿźĜſō

Źŵ

ƽźǀĮƄǀě

Żř

Ƶźě

ƾƀĜƯǈƧř

Źŵ

ƱŚƳŻ

Śŝ

ƾƟřźĭƺƳƺſ

źƬěřŵ

ƾƘǀŞƏźǀƛ

ƱŚƿźƃ

ƾưůŹ

źƟźŤĩŵ

ƿ

ŶůƺƯƵŶ

Î

ǇƶưƏŚƟźŤĩŵ

ŚƷƺƫ

Î

ƘƯŚƋŹźŤĩŵ

ǀ

ŶƫřƲ

ƿ

Ʋ

Ï

ƛŚŝŵŢƘƬƏźŤĩŵ

ƾ

ƶƘƬƣ

Î

ŻźŤĩŵ

ƿ

ŚƋŹŜƴ

ƾƿ

ŶŬƯ

Ð

ƵźƷŻźŤĩŵ

ƿ

ŵż

ƽ

Ñ

ƺƳ ƿ ƵŶƴƀ ƽ ƀƯ ƺ Ʃƹ ƹƱŚƳŻƵƹźĭ řŻ ƿ ƱŚư ƵŶĪƄƳřŵ ƽ Īƃżě ƾ ĪƃżěƭƺƬƗƵŚĮƄƳřŵ ƾ ƹżƣ ƿ ƹżƣƲ ƿ Ʋ lalooha44@yahoo.com ŢƟŚƿŹŵ çå æç îé ƁźƿŸě çå é îê Īģ ǀ ƵŶ ƯŻ ǀ ƝŶƷƹƶƴ ƶƷŵƶſŹŵ ƽ ųř ǀ ƄŴŝźŧřź ƾ źĜſōƝźƈƯ ƿ řźŝƮĩŻƹŵŚŝƲ ƽ ěǀ ĮƄ ǀź ƽ ƵźěŻř ƀĜƯǈĩř ƾ ƶŝ ƱřƺƴƗ ºƿ ƤŰţŹŵƮºƸƯƂºſźěĨ ǀ šŚºƤ ŚƯŚƯ ƾƿ ŢſřƵŵƺŝŭźƐƯ ř ƿ ŧŚţƝŶƷŚŝƶƘƫŚƐƯƲ ǀ ƺŬţź ƿ źĜſōż ƿ Ʋ ěŹƺƔƴƯƶŝ ǀ ĮƄ ǀź ƽ ƵźěŻř ƀĜƯǈĩř ƾ źěƱŚƳŻŹŵ ŚŝźƐų ƿ ƶºŤƟŚ ŚºƷ ƽ ƛ ǀź ŞƏ ǀ ºƘ ƾ Źŵ ƾƟřźĭƺƳƺſ źƬěřŵ źƃ ƿ ưůŹƱŚ ƾ ŶƃƭŚŬƳř ƁƹŹ ſŹźŝ ƾ ř ƿ ŚƯŻōŹŚĩƲ ƾƿ ƫŚŝ ǀƴ ƾ ƟŵŚƈţ ƾ ƩŚſŹŵŹƺĩƺſƹŵ æèîè ƃŻƺƯōżĩźƯŹŵ ƾ ƳŚƯŹŵ ƾ ƹżƣźŧƺĩ ƿ ŶƃƭŚŬƳřƲ ƬĩŹŵ ǀƶ į ŹřŵŹŚºŝƱŚºƳŻ ƺƬƣĨţ ææ Śţ æé ƶŤƠƷ ƟřźĭƺƳƺſ ƾ źƃźƬěřŵ ƿ ưůŹƱŚ ƾ ƭŚŬƳř Ŷƃ Źŵƹ ŵƺūƹšŹƺƇ ƿ ƶŤƟŚ ŚºƷ ƽ ƛ ºǀ ŞƏź ǀ ºƘ ƾ źºƬěřŵ ƱřŹŵŚºƯ Źŵ ƹŵ ŵŹƺºƯƵƹźºĭ êå źƠƳ ƹ ŶƷŚƃ êå źƠƳ ŶƳŶƃƶƘƫŚƐƯŵŹřƹ ƶƳřŻƹŹŵŹƺƯƵƹźĭ íå Ư ǀƬ ƾ ƭźĭ źĜſō ƿ ƹƲ ŚƃƵƹźĭ ƶƳřŻƹŹŶƷ ƿ ŹŵƺŞſǈěƅźƣĨ ƿ ŶƳŵźĩŢƟŚ Ʋƿř řŻƱŚƯŻŚţƵƹźĭƹŵ ƿ ěƱŚư ǀĮ ǀź ƽ ěƹŶƳŶƃ ǀ ŚƷŶƯŚ ƽ ŹřŵŹŚŝ ƽ ŻƹźŝƪƯŚƃ Ƶźě ƀºĜƯǈĩř ƾ ŵƹŶºŰƯ ƿ ºưůŹƪºųřŵŶºƃŹŢ ƾ řŻ ƿ ƁƹŹŽŹŵƹŻƱŚºư řŻ ƿ ƣŵŹŚĮěōƱŚư ǀ ƶƤ æ ƹ ê ŶƃŢŞŧŵřŻƺƳƱŻƹƹŵřŻƺƳ ƯŚưţ ƾ Ƶŵřŵ ƱƺƯŻōŚŝŚƷ ŚƷ ƽ ŹŚƯō ƽ T ŚĩŹƹŸŬƯƹ ƽ żŬţ ƿ ƬŰţƹƶ ǀ Ŷƃƪ ƿ ƶŤƟŚ ŚƷ ŵŹƺƯƵƹźĭŹŵ ë źƠƳ æç ŶƇŹŵ ŶƷŚƃƵƹźĭŹŵƹ æç źƠƳ çé ŶƇŹŵ ƀĜƯǈĩřƵźěŹŚģŵ ƾ ŶƳŶƃ ƫƹ ƾ řƿ źƔƳŻřƂƷŚĩƲ ŹŚºƯō ƽ ºƴƘƯ ƾ Źřŵ ŵƺŞƳ è å P= ŵƹŶŰƯźƔƳŻř ƿ ƴūŶƃŹŢ ǀ řŻƲ ƿ řŻƁƹŹŽŹŵƹŻƱŚư ƿ ƵźưƳƹƱŚư ƽ ƴƘƯšƹŚƠţŹŚĮěō ƾ Źřŵ ƽ ŝǀ ŵƵƹźĭƹŵƲ ƿ ŶƄºƳƵŶ Ư ºǀ ĮƳŚ ǀ Ʋ ưĩŵŹƺƯƵƹźĭŹŵƱřŵřŻƺƳƱŻƹ ƾ ŝǀ ŵƺŝŶƷŚƃƵƹźĭŻřźŤƄ åê å P= ŤƳǀ ƶŬ ĭǀ ź ƽ ƶƘƫŚƐƯ ƽ źƋŚů ƺŬţƶĩŵřŵƱŚƄƳ ƿ źĜſōż ƿ ŹřŵŹŚŝƲſŻřƲ ƽ æé ƶŝƶŤƠƷ ŹŵŶƘŝ ŚŝƱŚƳŻ ƿ ƶŤƟŚ ŚƷ ƽ ƛ ǀ ŞƏź ǀƘ ƾ źƬěřŵ ŻƹźŝźƐųŢƀƳřƺŤƳ ƀĜƯǈĩřƵźě ƾ ŶƷŵƂƷŚĩřŹ ƱŚĭĥřƹ ƽŶǀƬƧ ƲƿźĜſō ƾƟřźĭƺƳƺſ źƬěřŵ Ƶźě ƾƀĜƯǈƧř ěǀ ĮƬƯŚůŶƯŚ ƾ ƱŚƿźƃ ƾưůŹ æ řŻƹƱŚƳŻƆƈŴŤƯ ƿ ƱŚư ƄƳřŵ ǀ ƱŚƳŻƵƹźĭŹŚ ƹ řŻ ƿ ƱŚư ƵŶĪƄƳřŵ ƽ Īƃżě ƾ ĪƃżěƭƺƬƗƵŚĮƄƳřŵ ƾ ƹżƣ ƿ ƹżƣƲ ƿ Ʋ Ï ŵřŹƆƈŴŤƯ ƿ ĥƺƫƺ ƽ ŹŚƿŵŚŤſř ƵŶĪƄƳřŵ ƽ Īƃżě ƾ ĪƃżěƭƺƬƗƵŚĮƄƳřŵ ƾ ƹżƣ ƿ ƹżƣƲ ƿ Ʋ Ð Ťſŵ ǀ ŹŚ ƈƈŴţ ƾ řŻƹƱŚƳŻ ƿ ƱŚư ƵŶĪƄƳřŵ ƽ Īƃżě ƾ ƵŚĮƄƳřŵ ĪƃżěƭƺƬƗ ƾ ƹżƣ ƿ ƹżƣƲ ƿ Ʋ Ñ ŹŚĩŜƏƆƈŴŤƯ ŹŚǀƄƳřŵ ƤŰţżĩźƯ ǀ šŚƤ ƗŚưŤūřƪƯřƺƗ ƾ ŢƯǈſźŝźŧƺƯ ĪƃżěƭƺƬƗƵŚĮƄƳřŵ ƾ ƹżƣ ƿ ƹżƣƲ ƿ Ʋ

CORE Metadata, citation and similar papers at core.ac.uk

(2)

ƶƯŶƤƯ ƀĜƯǈĩřƵźě ƾ ºƿ ƬºƇřŢºƬƗĨ ƾ ƫŚºţŹƺƯ ǀŤ ƾ ŝŹƺƯƹ ºǀ Ŷƿ Ť ƾ ŹŵŚƯ ƽ źěƹ Ƶ ƯƩŚţŚƳ ƾ ŶƃŚŝ è æ ĮƳƺĮģ ƾ řƿ ŵŚŬ ºƿ ŶƄºţŚ ƿ Ŷ ŹřŵŹŚŝŹŵƱƺųŹŚƄƟ ƽ ƬƗ ǀ ƤŰţƮƛź ǀ ºſƹšŚºƤ ǀ ƶºƷŵŹŵƖ ŚºƷ ƽ ųř ǀ ƵŵŹŹŵŻƺƴƷź ƽ ƮƸƯ źţ ƿ ƵŶƄºƳƪºůšǈĪƄƯƲ į ŚºƯŚƯ ƾƿ ŻšǇřƺſƹƶŤƃřŵŹřźƣ ƿ ŵŚ ƽ řŹŵ ƿ ŝƶƐŝřŹƲ ƾ ŢſřƵŶƳŚƯŲſŚě é ººſŚſřƂƫŚººģ ƾ ŚººƯŚƯŹŵ ƾƿ ƱŹŶººƯ ŴƄººţ ǀ ŽŹŵƹŻƆ ŹřŵŹŚŝ ƽ ŚƷ ƾƿ ƀºĜƯǈĩřƵźºěŻƹźºŝźºƔƳŻřƶĩŢſř ƾ źºƐųźě Ư ƾ ŶƴƃŚŝ ê ưƷřƶŝƶūƺţŚŝ ǀ ŴƄţŢ ǀ źſƆ ƿ řƖ ƿ ƩǈŤºųřƲ ƵŻřŶƳř ĭ ǀź ƽ ŚƷźĩŹŚƯ ƽ ŴƯ ƠƬŤ ƾ řźŝ ƽ ºě ǀ ŝƂ ǀ ºƴ ƾ ř ºƿ ƶºƋŹŚƗƲ ěǀ ƫƹŢſřƵŶƃŵŚƸƴƄ ƾ Śţ ƷƱƺƴĩ ǀ źĮƫŚºŝźƛŢƀºţĢ ƽ źºŞŤƘƯ ưƏřƪŝŚƣ ǀ ƶƟźƇƶŝƱƹźƤƯƹƱŚƴ ř ƽ řƶŝ ƿ ºƟźƘƯŹƺƔƴƯƲ ƾ ƵŶƄºƳ Ţſř é ŹřŵŹŚŝŹŵ ƽ ŞƏ ǀƘ ƾ ƺƟƹźţƮūŚƸţ ŝ Ťſǈ ǀ ƯƶŝĨ ºǀ źŤƯƺ Ɯţƹ ǀǀ ĜſřơƹźƗƪĪƃź ǀ ºưůŹƩřź ƾ ŵƹŶºůŻřƶºĩ í ºĮŤƠƷ ƾ ƶŤƠƷŚţƹƕƹźƃ Ʒ Ś ƽ æë Śţ çå ƯƪƯŚĩ ƾ ŚƸƳŹŵŵƺƃ ƿ źºŬƴƯŢ řƶŝ ƿ ưůŹƱƺųƁŵźĭŵŚŬ ƾ ŤƠū ƾ ŚěŢƯƹŚƤƯŚŝ ƿǀ ºƯƲ ƾ ŵƺºƃ ƫƹ ƾ řƿ ƟŶƳƹŹƲ ǀż ƿ ĥƺƫƺ ƿ ƀĜƯǈĩřƵźěŹŵĨ ƾ ºƯƪºŤŴƯ ƾ ŵƺºƃ ë ƿ ƴĪţĨ ǀ ƛĨ ǀ ưūŚƸţź ƾ Ưƶĩ ƾ ƶŝŶƳřƺţ ƛŹƺƏ ºǀ ƤŤƀºƯź ǀ Ʈ řźŝ ƽ ſŹźŝ ƾ ƱƺųƁŵźĭ ƿ ŹřźºƣƵŵŚƠŤºſřŵŹƺºƯƩŚŤƴſǈěƹźţƺ ĭǀ ſŵź ƟřźĭƺƳƺ ƾ ưůŹơƹźƗźƬěřŵ ƾ Ţſř ì ƿ ƶŤƟŚ ŚƷ ƽ ƛ ǀ ź ŞƏ ǀƘ ƾ ƟřźĭƺƳƺſ ƾ źŝƪƯŚƃźƬěřŵ ƿ ĭŶ ƾ ƿ ƶƟźƏĨ ºƿ ƶºƟźƏƹŵŚ ŵũƺººƯŹŵ ƿ ƫƺŤººſŚ ǀ Ĩ řżººƟř ƿ ººƣƹźƗŢººƯƹŚƤƯƆųŚººƃƂ ƾ Resistance Index ºººƿ řżºººƟřŚ ƿ ƳŚŝźºººƋƆųŚºººƃƂ ƾ Pulsatility Index Ư ƾ ŶƃŚŝ Ŷƴģ ƿ řźŝƶƘƫŚƐƯƲ ƽ ŻŹř ƿŝŚ ƾ ƟřźĭƺƳƺſŹŚŞŤƗř ƾ źºƃźƬěřŵ ƿ ºưůŹƱŚ ƾ ƶºŝ ƱřƺºƴƗ ºƿ ŢƀºţĨ źĮƫŚŝźƛ ƽ ƀĜƯǈĩřƵźěŹŵ ƾ ŢſřƵŶƃƭŚŬƳř æå í ƶºŝ ŹƺºƏ ŞƏ ǀƘ ƾ ěŚŝ ǀ Ƅ ŹřŵŹŚŝŢƟź ƽ ºƣƹźƗŢºƯƹŚƤƯ ƾ źºƃŹŵ ƿ ƱŚ ŚºƷ ƽ ưůŹ ƾ ƯƂƷŚĩ ƾ ƿ ŶŝŚ řżƟřřŸƫ ƿ ƣƹźƗŢƯƹŚƤƯƂ ƾ ƿ źƷŚºƔţĨ ƫƹř ǀƶ į ŵřŹ ƿ Ɵřźĭƺ ǀ ƀĜƯǈĩřƵźěŹŵĨ ƾ Ư ƾ ŶƃŚŝ ææ ƺºſŻř ƽ ŵƿ ƴģŻřźĮ Ŷƿ ƶƷŵƲ į ŧŚţƪŞƣ ǀ ƺŬţź ƿ Ɵƹźěż ǀ Ťĩǈ ºǀ źĜºſōĨ ƿ Ʋ ŹŵƮĩŻƹŵŚŝ ěǀ ĮƄ ǀź ƽ ƵźěŻř ƀĜƯǈĩř ƾ ƶŝ ƱřƺºƴƗ ºƿ ƂºſźěĨ ƤŰţŹŵƮƸƯ ǀ ŚƯŚƯšŚƤ ƾƿ ŢºſřƵŵƺºŝŭźƐƯ ê ƛŶƷřƺºƃ ºǀ ź ƤŤƀƯ ǀư ƾ źĜſōƶĩŶƳŹřŵŵƺūƹ ƿ ƯƮĩŻƹŵŚŝƲ ƾ ƶºŝźŬƴƯŶƳřƺţ ŤſǈěƺƟƹźţƮūŚƸţŹŵŵƺŞƸŝ ƾ źºƃƶŝ ƿ ƱŚ ŚºƷ ƽ ěŹŚºƯ ǀ Ĥ ƾ ºůŹ Ʈ ŵƺƃ ë ƺſŻř ƽ ŵ ƿ ſŚſřƂƤƳƶŝƶūƺţŚŝźĮ ƾ ƮºſŚĜſřƹŻřƹ ººſō ǀ ƬţƹŶººƳřƩƺƬººſŜ ǀ ƩŚ ſƱŶººƃƩŚººƘƟƹ ººǀ ŵŚººƤƘƳřƮŤƀ ƽ Źŵ Ɵǀ żƿ ĥƺƫƺţŚěƺ ƽ Ƶźě ƀºĜƯǈĩř ƾ źĜºſō ƿ ƶºŝƲ ƱřƺºƴƗ ºƿ ƹŹřŵĨ ƽ ŤƳō ƾ ţƺŞƯƹźţ ǀ ŚƃĨ ƿ ĭƺƬūŹŵŶƳřƺŤŝŶ ǀź ƽ ŝŻƹźŝŻř ǀ ŹŚư ƽ ƂƤƳ ŤŞŨƯ ƾ ŶºƃŚŝƶŤƃřŵ é ƤŰţŹŵ ǀ ţŚºƤ ƾ ƺºŬţƶºĩ ƿż źĜºſō ƿ ŻřƲ ƶŤƠƷ į æë ŹřŵŹŚŝ ƽ ŚºŤƳƵŶƃŻŚƛō ƿ ĩŚºůŪ ƾ ŵƹŶºůƂƷŚºĩŻř æå ŶºƇŹŵ ƽ ŻƹźºŝŹŵ ƀººĜƯǈĩřƵźºě ƾ ŢºſřƵŵƺºŝ æç ŚººƯř ƫŚƳōŚŤƯ ǀ ŚƷż ƽ Ŷū ƿ ĩŚůźţŶ ƾ ŹŵƶĩŢſřƱōŻř ƺºŬţšŹƺƇ ƿ ż źĜººſō ƿ ƶººŤƠƷŻřƪººŞƣƮººĩŻƹŵŚººŝƲ į æë ŹřŵŹŚººŝ ƽ Żƹźººŝ Ƶźě ƀĜƯǈĩř ƾ Śţ êå ŶƇŹŵ ŶºƷřƺųƂƷŚĩ ƿ ŢºƟŚ æê æè Śºŝ Ɵƶŝƶūƺţ ǀż ƿƺ ƺţŚě ĥƺƫ ƽ ƀĜƯǈĩřƵźě ƾ ŶºŞţƶºĩ ƿ źºƃƪ ƿ ƱŚ ŚºƷ ƽ Ĝſř ǀ ưůŹƩřź ƾ źºƃƶŝ ƿ ƱŚ ŚºƷ ƾƿ ŚºěŢºƯƹŚƤƯŚºŝ ǀƿ ƶºŤƠƷŻřƲ į í ŹřŵŹŚŝ ƽ ƶŤƠƷŚţƹƕƹźƃ ŚºƷ ƽ æë Śºţ çå ưĪţ ºǀ ºƯƪ ƾ ŵƺºƃ źĜſōƕƹźƃ ƿ ŹřŵŹŚŝƲſŹŵƲ ƽ Śě ǀƿ Ʋ Śƃźţ ƿ ŢºƸūŹŵŶºƳřƺŤŝŶ ŝŻƹźŝƂƷŚĩ ǀ ŹŚư ƽ ŶƃŚŝƵŶƴƴĩĨưĩ řŸƫ řƿ ƝŶƷŚŝƶƘƫŚƐƯƲ ſŹźŝ ƾ ŧŚţ ǀ ź ƺŬţ ƿ ż ŽŹŵƹŻ źĜſō ƿ ƮºĩŻƹŵŚŝƲ ƶºŤƠƷŻř ŚºƷ ƽ Śěƿ ǀ ŹřŵŹŚŝƲ ƽ æé ĮŤƠƷ ƾ ěŹŵ ǀ ĮƄ ǀź ƽ ƵźºěŻř ƀºĜƯǈĩř ƾ Źŵ ŚŝƱŚƳŻ ƿ ƶºŤƟŚ ŚºƷ ƽ ƛ ºǀ ŞƏź ǀ ºƘ ƾ Źŵ ƟřźĭƺƳƺºſ ƾ źºƃźºƬěřŵ ƿ ƱŚ ưůŹ ƾ ŶƃƭŚŬƳř ƁƹŹ ſŹźŝ ƾ ř ººƿ ŚººƯŻōŹŚĩƲ ƾƿ ƫŚººŝ ǀƴ ƾ ƟŵŚƈººţ ƾ ŻřžººěŹƺĩƺººſƹŵ Śţ ººǀƿ ưĩŹŵŶ ǀ ƶººŤ į ĪººƃżěƭƺººƬƗƵŚĮƄººƳřŵơǈººųř ƾ ƹżººƣ ƿ Ʋ ííêè çå çí ŚĩżººĩźƯŹŵŢººŞŧƹ Ź ŚººƯŻō ƾƿ ƫŚººŝ ǀƴ ƾ ř ººƿ Ʊřź IRCT201505103025N5 ƩŚºººſŹŵ æèîè żºººĩźƯŹŵ ƃŻƺƯō ƾ ƳŚƯŹŵ ƾ ŶƃƭŚŬƳřźŧƺĩ Ƭĩ ǀƶ į ƺºƬƣĨºţŹřŵŹŚºŝƱŚƳŻ ĮƬƯŚůƲſŚŝ ƾ ææ Śºţ æé ŚºĮƳŚƯŹŵƶºŝƶºĩƶºŤƠƷ ƩŚºţŚƳƵźºěƵ ŝǀ ƱŚŤſŹŚư ƶƘūřźƯ ƟřźĭƺƳƺſƭŚŬƳřŢƸūŶƳŵźĩ ƾ ơƹźƗźƬěřŵ

(3)

ººưůŹ ƾ ƶººŝ ººƿ ƟřźĭƺƳƺººſżººĩźƯĨ ƾ ŶƳŶººƃƕŚººūŹřŶººůřƹ ƟřźĭƺƳƺſ ƾ ƎſƺţźƬěřŵ ºƿ ŵřŹĨ ƿ ĥƺƫƺ ºƿ ŚºŝŢƀ ºƿ ƵŚĮŤºſŵĨ ƟřźĭƺƳƺºººſ ƾ

GE: Voluson 730 Expert

žƳŚºººĩźƟƹ ê żţźƷŚĮƯ ƽ ŶƃƭŚŬƳř ƘƯŵƺūƹšŹƺƇŹŵ ǀ ŚƷŹŚ ƽ ƛ ǀ ŞƏź ǀƘ ƾ ƟřźĭƺƳƺſŹŵ ƾ ƶŝźƬěřŵ ƺºƇ źŝƶºƳƺĭźƷšŹ ºƿ ĭŶ ƾ ŵ ƿ ƫƺŤºſŚ ǀ Ĩ ƿ ƶºƟźƏĨ ºƿ ƶºƟźƏƹŵŚ ºƿ řżºƟřŚ ƿ źºƃŢºƯƹŚƤƯƂ ƿ ºưůŹƱŚ ƾ ëî å RI≥ ŶƳŶƃƶƘƫŚƐƯŵŹřƹŹřŵŹŚŝƱřŹŵŚƯ ƘƯ ǀ ŚƷŹŚ ƽ ũƹźų ŝƪƯŚƃ ǀ ŹŚư ƽ ƯŻ ǀ ƶƴ ř ƽ ŞƬƣ ƾ ŶŞĩ ƽ Ƭĩ ǀƺ ƽ ţǀ ŗƹź ǀ Ŷ ƶƤŝŚſ į ŤĜěƮųŻ ǀ ſŚƀůƹƮſōƶƤŝŚſĨ ǀ źĜſōƶŝŢ ƿ ŵƺºŝƲ řŶºŤŝřŹŵ ţƭŚŬƳřŻřƝŶƷ ƤŰ ǀ Ƣ ưƷř ǀ ƹŹřŵƮƔƴƯƝźƈƯŢ řźŝ ƽ ƱřŹŵŚƯ Ƌƺţ ǀ ƵŵřŵŮ Ŷƃ ŚƋŹƹ ƿ ƶƯŚƳŢ į ŵźĭŸųřƶƳŚƷŚĭō ƿ Ŷ ƶūƺţŚŝ ƶƘƫŚƐƯƶŝ į ƺƃřźŝř ŚƠƫōƲŤƟźĭźƔƳŹŵŚŝƹ ƽ ƹŚƀƯ ƽ åê å ŚºŤŝ ƶƘƫŚƐƯƱřƺţ ƿ ŚƐųŚ ƽ ƭƹŵƕƺƳ ƹŚƀƯ ƽ ç å ƵƹźºĭŹŵŻƹźŝƹ źŝřźŝƩźŤƴĩ ê ëæ ŶƇŹŵ źĜºſōŚºŝƱŚºƯŹŵƵƹźĭŹŵƹ ƿ Ʋ źºŝřźŝ èê ŶƇŹŵ řźŝƶƳƺưƳŵřŶƘţ ƽ ŚŝźŝřźŝƵƹźĭźƷ êå ƶŞºſŚŰƯźƠƳ ŵźĭ ƿ Ŷ æë ƘƫŚƐƯŵŹƺƯŵřźƟř šŹŚºĩśŚŴŤƳřŚŝƶ ŚºƷ ƽ ºĮƳŹ ƾ ƹŵŹŵ Ƶƹźºĭ ŶººƴŤƟźĭŹřźººƣŶƷŚººƃƹŵŹƺººƯ Źŵ ººƫƹř ǀ ƹƲ ƿż ººƿ Ţ šŚƈººŴƄƯ ƺƯŵ Ɵřźĭ ǀ ƲſƪƯŚƃĨ ƵŵƺţƆųŚƃ į ƳŶŝ ƾ ŹřŵŹŚºŝŵřŶƘţ ƽ ſƱƺųŹŚƄƟ ǀ ƫƺŤƀ ǀ Ĩ ƹ ŵƿ ƺŤſŚ ƫǀ Ĩ ŶƃŢŞŧ ŵŹƺºƯƵƹźºĭƶŝ êå Ƴ źƠ ƶŤƠƷŻř æé Śţ èì ŹřŵŹŚŝ ƽ ƶºƳřŻƹŹ ºƿ ƅźºƣŵŶºƗĨ źĜſō ƿ Ʋ íå Ư ǀƬ ƾ Ưźĭ ƾ ƂŴěƹŹřŵƶƳŚųŹŚĩŢųŚſ ƺŬţ ƿ Ŷƃż ŶƷŚƃƵƹźĭ êå źºƠƳ Ƴºǀ ƶºƳřŻƹŹż ºƿ ƺŞºſǈěƅźºƣŵŶºƗĨ Źŵ ƿ ŶƳŵźĩŢƟŚ ƶºŤƠƷŚºţŹřŵŹŚŝƱřŹŵŚƯ į çí ĮƬƯŚºů ƾ ƹŵźºƷ ƶŤƠƷ ŚůƮŤųƱŚƯŻŚţžĜſƹ ĮƬƯ ƾ ĮŤƠƷ ƾ ƹ ƿż ƿ ŶƳŶºƃŢ Źŵ ƹźƷ ƿż ƿ ŶƃƩřƺſƹŹřŵŜţźƯƝźƈƯƶŝƖūřŹŢ ŵřźƟř ƽ ƶºĩ ƏŹŵ ƾ ŹřŵŹŚŝ ƽ ŹŚģŵ ŝƱƺºųŹŚƄƟ ºǀ źŤƄ ºƿ ƹŚƀºƯŚ ƽ îå æéå Ưǀ Ƭ ƾ ūźŤƯ ǀ ŘţƹźěƵƺ ǀ ŝƲ ǀ ŻřźŤƄ æ ŹřƺºƳŢƀºţŹŵ ƽ ŹřŹŵř ºƿ Ś ţƹźě Řǀ Źƺƴ ƽ ŝǀ ŻřźŤƄ èåå Ư ǀƬ ƾ řŹŵƭźĭ ŹřŹŵ çé ŶƳŶºƃƶŤƗŚſ źƔƳŢŰţ źĭŹřźºƣ ƹƶºŤƟ ŴƄºţŽŚºſřźŝ ǀ ƀºĜƯǈĩřƵźºěƆ ƾ Ơų ǀ ƞ ƿ ŶƃŚ ƿ Ŷ ŻǇšŚƯřŶƣř ƮŤºųŢƸūƭ ºƿ ŹřŵŹŚºŝƶºƯřŵřŚ ƽ ƭŚŬƳř Ŷƃ ºưůŹƪºųřŵŶºƃŹƩǈŤºųřƶºŝĨƃšŹƺƇŹŵ ƾ ƴū ǀ ƟřźĭƺƳƺſƲ ƾ źƃźƬěřŵ ƿ ƟŚƳƱŚ ƾ żºƜƯ ƽ Ư ºǀ ƳŚ ƾ ƹ řźºŬƯ ƽ Źƹ ƿ Ŷ ƽ ŚţŢƸū ǀƿ Ŷ ƿ ŵŹŚ ŵƹŶŰƯ ƿ ưůŹƪųřŵŶƃŹŢ ƾ ºƴū ǀ Ʋ IUGR ŶƃƭŚŬƳř Ƭĩ ºǀ ƶ į ř ŚěŚºţŵřźºƟ ºƿ ŹřŵŹŚºŝƱŚ ƽ ŢºŰţ ěƹƵŵƺŝŢŞƣřźƯ ǀ ŚƷŶƯŚ ƽ ĮƬƯŚů ƾ ƀºĜƯǈĩřƵźºěŻƹźŝƪƯŚƃ ƾ ŵƹŶŰƯ ƿ Ţ ưůŹƪųřŵŶƃŹ ƾ ºƴū ǀ řŻƲ ƿ ƁƹŹŽŹŵƹŻƱŚºư řŻ ƿ ŶƃŢŞŧƱŚư ƳŶƫƺţŻřžě ǀż ƣŵŹŚºĮěō ǀ ƶºƤ į æ ƹ ê ƱŻƹƹ ŵřŻƺƳ ŵźĭŢŞŧ ƿ Ŷ ƿ ƶŤƟŚ ƭźƳŚŝŚƷ ŹřżºƟř æî SPSS ƹ Ţƀºţ ŚºƷ ƽ ŹŚƯō ƽ T-Test ƹ Chi-square żŬţ ƿ ƬŰţƹƶ ºǀ Ŷºƃƪ ŮƐºſ ƴƘƯ ƾ Źřŵ ƽ åê å P< ŵ Ź ŶƃƶŤƟźĭźƔƳ ƿ ŚƷƶŤƟŚ èéí ƟřźĭƺƳƺſŢŰţŹřŵŹŚŝŹŵŚƯźƠƳ ƾ źƃźƬěřŵ ƿ ưůŹƱŚ ƾ ƶĩŶƴŤƟźĭŹřźƣ æåë źƠƳ ƿ ŚƷƶŤƟŚ ƽ ƛ ǀ ŞƏź ǀƘ ƾ ŶƴŤºƃřŵźƬěřŵ Żř řƿ ŝźƠƳƶſŵřŶƘţƲ ƶ ƫŚƯƺƳōŢƬƗ ƾ ƴū ǀƴ ƾ ŶƳŚĩ ƿ ƳƺƳŚƣƎƤſŶ ƾ ƹŶƳŶƃ è ưůŹƪųřŵīźƯŢƬƗƶŝƮƷźƠƳ ƾ ºƴū ǀ ƲºſŹŵƲ æë ĮŤƠƷ ƾ ŶƳŶƃũŹŚųƶƘƫŚƐƯŻř ŚƸƳŹŵ ºƿ Ţ æåå ƹŵŹŵźºƠƳ ŶƴŤƟźĭŹřźƣŶƷŚƃƹŵŹƺƯƵƹźĭ ƯźƔƳŻř ºǀ ĮƳŚ ǀ ŵřŶºƘţƲºſƲ ŹřŵŹŚŝ ƽ ƵŵƺºţƆųŚºƃ į ƳŶºŝ ƾ ſƱƺºųŹŚƄºƟ ºǀ ƫƺŤƀ ǀ ƹĨ ŵƿ ƫƺŤººſŚ ǀ ººƴƘƯƝǈŤººųřƵƹźººĭƹŵŹŵĨ ƾ Źřŵ ƽ ŵ ººƿ ŶƄººƳƵŶ ƩƹŶū æ

(4)

ƩƹŶū æ ŚƤƯ ƿ ƶƀ į ƟřźĭƺƯŵšŚƈŴƄƯ ǀ ŶƷŚƃƹŵŹƺƯƵƹźĭƹŵŹŵĨ ƴƘƯŮƐſ ƾ Źřŵ ƽ źƠƳêåŵŹƺƯƵƹźĭ źƠƳêåŶƷŚƃƵƹźĭ ŚƷźǀƜŤƯ åë å çê ìtéì çéåétéè ƩŚſƲſ è å çêççtéæ çé åtçí kg/m2 ƾƳŶŝƵŵƺţƆųŚƃ é å æåít íåé æåîtìé mmHg ĨǀƫƺŤƀǀſƱƺųŹŚƄƟ í å ìétëè ìétëë mmHg ĨǀƫƺŤſŚƿŵƱƺųŹŚƄƟ í å çîêí çëêç řŻŢƀŴƳ ƯšŹƺƇƶŝŵřŶƗř ǀ ĮƳŚ ǀ ƘƯƝřźŰƳřƹƲ ǀ ŝŹŚ ǀ ŢſřƵŶƃƱŚ ŵřŶƘţšŹƺƇƶŝŵřŶƗř ŶƇŹŵ ŝ ǀ ŢſřƵŶƃƱŚ ŵŹƺƯƵƹźĭŹŵ ë źƠƳ æç ŶƇŹŵ ƀĜƯǈĩřƵźěŹŚģŵ ƾ ƶĩŶƳŶƃ é źƠƳ í ŶƇŹŵ ƠųƕƺƳ ǀ ƹƞ ç źƠƳ é ŶºƇŹŵ ŶºƃƕƺºƳ ƿ Ŷ Ƶźě ƀĜƯǈĩř ƾ ŶƴŤƃřŵ ŶƷŚƃƵƹźĭŹŵ æç źƠƳ çé ŶƇŹŵ ŹŚģŵ Ƶźě ƀĜƯǈĩř ƾ ŶƳŶƃ řŻřƶĩ ƿ ŵřŶºƘţƲ ì źºƠƳ æé ŶºƇŹŵ ƕƺºƳ Ơų ǀ ƞ ê źƠƳ æå ŶƇŹŵ ƕƺƳ Ŷƃ ƿ Ŷ Ƶźě ƀĜƯǈĩř ƾ ŶƴŤƃřŵ źƷ ƵŶƴƴĩƝźƈƯƵƹźĭŹŵŶƴģ į źĜºſō ƿ řźºƟřŵřŶºƘţƲ ƶºŝǈŤºŞƯŵ Ƶźě ƀĜƯǈĩř ƾ ºƫƹŵƺºŝźºŤưĩƺŞºſǈěƵƹźĭƶŝŢŞƀƳ ƾ ƱƺºƯŻō ŹŚƯō ƽ ƴƘƯšƹŚƠţ ƾ Źřŵ ƽ ƵźěƶŝǈŤŝřŹŵ ƀĜƯǈĩř ƾ ŝǀ ƵƹźĭƹŵƲ ŵřŶƳƱŚƄƳ è å P= ŵŹƺºƯƵƹźºĭŹŵ æ ŵřŻƺºƳ ç ŶºƇŹŵ Śºŝ ŴƄţ ǀ Ɔ IUGR ƟřźĭƺƳƺſƎſƺţƶĩ ƾ źƬěřŵ Śţ ǀƿ ŵƺºŝƵŶºƃŶ ŶºƃŶƫƺŤƯ ŴƄºţ ǀ Ɔ IUGR Źŵ è ŵřŻƺºƳ ë ŶºƇŹŵ Ƶƹźºĭ ŶƷŚƃ Ƶŵřŵ Ŷƃ ƶĩ ºƴƘƯšƹŚºƠţźĮƳŚƄƳ ƾ Źřŵ ƽ ºŝ ǀ ƵƹźºĭƹŵƲ ŵƺŞƳ ë å P= řŻƕƺºƳźºƔƳŻř ƿ ŵŹƺºƯƵƹźºĭŹŵƱŚºư çæ źºƠƳ éç ŶƇŹŵ Źřżſ ƿ řŻřƶĩŶƳŶƃƲ ƿ ŵřŶƘţƲ ì źƠƳ æé ŶƇŹŵ ƀºĜƯǈĩřƵźěŢƬƗƶŝ ƾ Źřżºſ ƿ ŶƳŶºƃƲ ƮºƷŶƷŚºƃƵƹźºĭŹŵ çæ źƠƳ éç ŶƇŹŵ Źřżſ ƿ ƬƗƶĩŶƳŶƃƲ ŹřżſŢ ƿ ŹŵƲ é źºƠƳ í ŶƇŹŵ ƀĜƯǈĩřƵźě ƾ ŵƺºŝ æ P= Ư ºǀ řŻƱřż ƿ ŽŹŵƹŻƱŚºư źŤưĩ Żř èì ƶŤƠƷ źĜſōƵƹźĭŹŵ ƿ Ʋ ê ŵŹƺƯ æå ŶƇŹŵ ŵƺºŝ řŻřƶĩ ƿ ŵŹřƺƯƲ è źƠƳ ë ŶƇŹŵ ƀĜƯǈĩřƵźěŢƬƗƶŝ ƾ Ƴǀ ƶŝŻŚ ų ĮƬƯŚůƮŤ ƾ ŻřƪŞƣ èì ŶƴŤƃřŵƶŤƠƷ ƺŞſǈěƵƹźĭŹŵ æå źºƠƳ çå ŶƇŹŵ řŻ ƿ ƱŚư ŶƴŤºƃřŵŽŹŵƹŻ Źŵ é ŵŹƺºƯ í ŶºƇŹŵ ŝƶ ŢƬƗ ƀĜƯǈĩřƵźě ƾ ĮƬƯŚůƮŤų ƾ řƶĩŶƃƭŚŬƳř ºƿ šƹŚºƠţƲ Ƴǀ ƴƘƯƵƹźĭƹŵŹŵż ƾ ŵƺŞƳŹřŵ ë å P= ƩƹŶū ç ŚƤƯ ƿ ƶƀ į ěǀ ŚƷŶƯŚ ƽ ŹřŵŹŚŝ ƽ ŶƷŚƃƹŵŹƺƯƵƹźĭƹŵŹŵ ƴƘƯŮƐſ ƾ Źřŵ ƽ źƠƳêåŵŹƺƯƵƹźĭ źƠƳêåŶƷŚƃƵƹźĭ ŚƷźǀƜŤƯ èå å ëæç æççé ƾƀĜƯǈĩřƵźě ëå å æç èë ƾưůŹƪųřŵŶƃŹŢƿŵƹŶŰƯ ëå å êæå æåçå ŽŹŵƹŻƱŚưƿřŻ åå æ çæéç çæéç ƲƿŹřżſ æç å í îtåè í ìtåê æƶƤǀƣŵŹŚĮěō ëå å î îtåæ î ítåê êƶƤǀƣŵŹŚĮěō åê å èåìétèíé çíìêtëåå ƭźĭŵřŻƺƳƱŻƹ ŵřŶƗř ŵřŶƘţšŹƺƇƶŝ ŶƇŹŵ ŝ ǀ ŢſřƵŶƃƱŚ ƶŝŵřŶƗř ƯšŹƺƇ ǀ ĮƳŚ ǀ ƘƯƝřźŰƳřƹƲ ǀ ŝŹŚ ǀ ŢſřƵŶƃƱŚ

(5)

Ưǀ ĮƳŚ ǀ ƣŵŹŚĮěōƲ ǀ ƶƤ æ ƹ ê ƳƱřŵřŻƺºƳ ºǀ šƹŚºƠţƵƹźºĭƹŵŹŵż ŹŚƯō ƽ ƴƘƯ ƾ Źřŵ ƽ ŢƃřŶƳ æç å P= Ưǀ ĮƳŚ ǀ ŹŵƱřŵřŻƺƳƱŻƹƲ źĜſōƵƹźĭ ƿ ĩŶƳřƲ ƾ ǈěƵƹźºĭŻřźţǇŚºŝ ŵƺºŝƺŞºſ åê å P= ƩƹŶū ç ŦŰŝ ƿ ƶŤƟŚ ŚƷ ƽ ƶƘƫŚƐƯ į ƺºŬţƶĩŵřŵƱŚƄƳźƋŚů ƿ źĜºſōż ƿ ŻřƲ ŹřŵŹŚŝƲſ ƽ æé ƶŝƶŤƠƷ ŹŵŶƘŝ ŚŝƱŚƳŻ ƿ ƶŤƟŚ ŚƷ ƽ ƛ ºǀ ŞƏź ǀ ºƘ ƾ źƃźƬěřŵ ƿ ưůŹƱŚ ƾ ƵźěŻƹźŝŻřŢƀƳřƺŤƳ ƀºĜƯǈĩř ƾ ě ºǀ ĮƄ ǀź ƽ Ŷƴĩ řŻŻƹźºŝźƔƳŻř ƿ ŽŹŵƹŻƱŚºư ŵƹŶºŰƯ ƿ ƪºųřŵŶºƃŹŢ ưůŹ ƾ Ƴǀ ż ŹŚºƯōšƹŚƠţƵƹźĭƹŵŹŵ ƽ ƶºƔůǈƯƪºŝŚƣ ř ƽ ŵ ºƿ ƵŶ ŶƄƳ ƯŚƸƴţ ǀ ĮƳŚ ǀ źĜſōƵƹźĭŹŵƱřŵřŻƺƳƱŻƹƲ ƿ ưĩƲ ƾ ŻřźţǇŚŝ ŵƺŝŶƷŚƃƵƹźĭ åê å P= ƤŰţƩŚºůƶºŝŚţ ǀ ŻšŚºƤ ºƿ ŵŚ ƽ Źŵ źĜſōƝźƈƯŚŝƶƐŝřŹ ƿ ěŹƺƔƴƯƶŝƲ ºǀ ĮƄ ǀź ƽ ƵźºěŻř ƀºĜƯǈĩř ƾ ŚºŤƳƶºĩƵŶºƃƭŚºŬƳř ƿ ƤƳƹŶººƋŪ ºǀ ƌ ƾ ºěŹŵ ƾ ŢººſřƶŤºƃřŵ Ʒ ŹŚ ƿ ƩŚſŹŵƱƺŤĮƴ çååå źĜſō ƿ ŻƹŵŚŝƲ æåå Ư ǀƬ ƾ ƶºŝřŹƭźĭ ƛźƬěřŵŚŝŹřŵŹŚŝƱŚƳŻ ǀ ŞƏź ǀƘ ƾ źƃ ƿ ŹƱŚ ưů ƾ ŹřŵŹŚºŝƲſƶĩ ƽ æì Śţ çè ƶŤƠƷ ƺŬţŶƴŤƃřŵ ƿ ŵźĩż ŚŤƳ ƿ ƶºĩŵřŵƱŚƄƳƶƬƇŚůŪ ƴƘƯšƹŚƠţ ƾ Źřŵ ƽ ƵźěźƔƳŻř ƀĜƯǈĩř ƾ ŶºƫƺţƖºƣƺƯƮºĩƱŻƹ řŻƕƺƳ ƿ źĜſōƵƹźĭŹŵƱŚư ƿ ƶŝŢŞƀƳƲ ŵŶƷŚƃƵƹźĭ ºƿ ŶƄºƳƵŶ æì ƕƹźƃŶƴģźƷ ƺºŬţ ƿż źĜºſō ƿ ŹŚºƷƶºƘƫŚƐƯŹŵƲ ƿ ƱƺŤĮƴ ƶƘƫŚƐƯƶŝŢŞƀƳ į ŹřŵŹŚºŝƲºſŹŵźƋŚů ƽ ºƫƹƵŵƺºŝźţǇŚºŝ ƾ ŚŤƳ ƿ ƮƷŚƯƂƷƹĦěŚŝƶƬƇŚůŪ Ƴřƺų ƾ ŵŹřŵ ƶƘƫŚƐƯŹŵ į řźĭ ś ƺŬţ ƿ źĜſōż ƿ Ʋ íå Ư ǀƬ ƾ ƶºŤƠƷŻřƶºƳřŻƹŹƭźºĭ æí ŹřŵŹŚºŝ ƽ Źŵ ŚƤƯ ƿ řƺŤƳƺŞſǈěŚŝƶƀ ƄºƷŚĩŢƀºƳ ƾ ƵźºěŻƹźºŝŹŵ ƀºĜƯǈĩř ƾ řƿ ŶƴĩŵŚŬ æí řŹŵ ºƿ ƳƶºƘƫŚƐƯƲ ºǀ ŹřŵŹŚºŝƲºſż ƽ Źŵ ƱŚºƯŻ ƶƘƫŚƐƯƶŝŢŞƀƳƶƘƫŚƐƯƕƹźƃ į ºƫƹƵŵƺºŝźţǇŚºŝŚƯ ƾ ŚºŤƳ ƿ Ū ŵŹřŵƢŝŚƐţƮƷŚŝƶƬƇŚů ƟƶŝƶūƺţŚŝ ǀż ƿ ĥƺƫƺţŚºěƺ ƽ ŹřŵŹŚºŝ ƽ ŞƏ ǀ ººƘ ƾ ưĪţƹ ººǀ ŶººƳƹŹƪ Placental Implanation ƲººſŹŵ ŹřŵŹŚŝ ƽ æé Śţ æí ƯŹŚƔŤƳřƶŤƠƷ ƾ ƜţƶĩŵƹŹ ǀǀ řšřź ƿ ƵŶºƃŵŚŬ źƃŹŵ ƿ ưůŹƱŚ ƾ ŶŞţ ƿ ŢƯƹŚƤƯƮĩƶŝŢƯƹŚƤƯźěơƹźƗŻřƪ ưƷŹŵ ǀ ƵŻŚŝƲ į ƳŚƯŻ ƾ ƵŵřŵűŹ ë ƯźƔƳƶŝřŸƫƹ ƾ ŧŚºţŶſŹ ǀź ŢŞŨƯ źĜſō ƿ ěŹŵƲ ǀ ĮƄ ǀź ƽ ƵźěŻƹźŝŻř ƀºĜƯǈĩř ƾ ţŹƺºƇŹŵ ƾ ƯơŚƠţř ƾ ƺŬţƶĩŶŤƟř ƿ ƴſŹŵƹŹřŵż ǀ ŹřŵŹŚºŝƲ ƽ Ż ºƿ ź æé ƶºŤƠƷ ŵƺƃŻŚƛō ƫƹ ƾ źĜſōŽŹŵƹŻƕƹźƃ ƿ ƭŚºưţŹŵƶŤƀºƳřƺŤƳƮºƷƲ ŚưůƱōŢŞŨƯƂƤƳŻřšŚƘƫŚƐƯ ºƿ ŶºƴĩŢ ƶºƘƫŚƐƯƶºƬưūŻř ƽ ŵƿ źĮ ƽ Ǝſƺţ ǈƿƹ ƩŚſŹŵ çåæç ſŹźŝƝŶƷŚŝ ƾ źĜſōźŧř ƿ Ʋ ěŹŵ ǀ ĮƄ ǀź ƽ ƵźěŻř ƀĜƯǈĩř ƾ ŶƃƭŚŬƳřźƐųźěƱŚƳŻŹŵ ƱřŹŵŚƯ ŹřŵŹŚŝƲſŚŝ ƽ æç Śţ æé řŵƶºĩƶŤƠƷ ƛźºƬě ºǀ ŞƏź ǀ ºƘ ƾ źºƃ ƿ ƱŚ ººưůŹ ƾ źĜººſōƝźƈººƯƵƹźººĭƹŵŹŵŶƴŤººƃřŵ ƿ ŻƹŵŚººŝƲ æåå Ưǀ Ƭ ƾ ŶƴŤƟźĭŹřźƣƺŞſǈěƝźƈƯƹƶƳřŻƹŹƭźĭ ŚºŤƳ ƿ ƶƬºƇŚůŪ ƠƯźŧřŢƀƳřƺŤƳ ǀ Ŷ ƽ řźŝ ƽ ƺŬţ ƿ źĜºſōż ƿ ŹŵźºƐųźěƱŚºƳŻŹŵƲ ěǀ ĮƄ ǀź ƽ ƀĜƯǈĩřƵźěŻř ƾ ŶƴĩšŚŞŧřřŹ æî ŚŤƳ ƿ ŚƯŻōŹŚĩŪ ƾƿ ƫŚŝ ǀƴ ƾ ƩŚſŹŵƶĩ çååê Ǝſƺţ ƾƃřźŝř ƶºĩŵřŵƱŚƄƳŶƃƭŚŬƳř ƺŬţ ƿż ìê Ư ǀƬ ƾ ƭźĭ źĜſō ƿ ŹřŵŹŚºŝƱŚºƳŻƶŝƶƳřŻƹŹƲ æé Śºţ æë ƶŤƠƷ Śŝ ƿ ƶŤƟŚ ŚƷ ƽ ƛ ǀ ŞƏź ǀƘ ƾ ƵźěŻƹźŝźƬěřŵ ƀĜƯǈĩř ƾ ƂƷŚĩřŹ ƫƹŵřŵ ƾ řźºŝ ƽ ºſŹźŝ ƾ ěŹŵƹŹřŵźºŧř ºǀ ĮƄ ǀź ƽ Żř ŵƹŶºŰƯ ƿ Ţ ưůŹƪųřŵŶƃŹ ƾ Ƈƺţ ǀ ŝšŚƘƫŚƐƯƭŚŬƳřƶŝƶ ǀ ŶƃźŤƄ źºƔƳŻř Ưǀ ĮƳŚ ǀ ƳƱřŵřŻƺƳƱŻƹƲ ǀ ƟǈŤųřż ƾ ƶĩŶƄƳƵŶƷŚƄƯ řºƿ ƂºŴŝƲ ŚŤƳŻř ƿ ŤƳŚºŝŪ ǀ ƶºŬ į ƶºƘƫŚƐƯ ƽ ŢºſřšƹŚºƠŤƯźºƋŚů ƶºŤŞƫř ƘƯ ǀ ŚººƷŹŚ ƽ ƶººƘƫŚƐƯƶººŝŵƹŹƹ ƾººƃřźŝř ƘƯŚººŝ ǀ ŚººƷŹŚ ƽ ƶººŝŵƹŹƹ ƶƘƫŚƐƯ į ŚƯ ƿ ŢſřƵŵƺŞƳƱŚƀĪ ŵƶƬưūŻř ƿ ŶƴƣŢŝŚ ƽ ŹŚƄºƟƹ Ʊƺų ƾſŚſř Ƴƹ ǀ ƶƘƫŚƐƯƱōŹŵƶƳƺưƳƮŬůż æèî ŹřŵŹŚºŝƱŻ ƶƘƫŚƐƯƶŝŢŞƀƳƶĩƵŵƺŝ į ŝƶºƳƺưƳŵřŶºƘţźºƋŚů ºǀ ƵŵƺºŝźŤƄ Ţººſř æë ƫŚººƳōŚŤƯŹŵ ǀ ż Ŷººƫƺūƺŝ ŧŚººţ ǀ źĜººſōƕƹźººƃź ƿ Ʋ Źŵ ƶŤƠƷ ŚƷ ƽ ŹřŵŹŚŝ ƽ ŻřźŤưĩ æë ƶŤƠƷ æë Śºţ æî ŻřžºěƹƶºŤƠƷ çå ƛźºƬěřŵŚŝźƐųźěƱŚƳŻŹŵƶŤƠƷ ǀ ŞƏź ǀ ºƘ ƾ ěŹŵ ºǀ ĮƄ ǀź ƽ Żř ƀĜƯǈĩřƵźě ƾ ſŹźŝŵŹƺƯ ƾ ĭŹřźƣ ŢºƟź ŚºŤƳ ƿ ŢºŝŚŧƶƬºƇŚůŪ ƱŚƯŹŵƕƹźƃƶĩŵźĩ źĜſōŚŝ ƿ ƶŤƠƷŻřƪŞƣƲ æë ŹřŵŹŚŝ ƽ ŜŞſ ƵźěŻƹźŝŹŵƶūƺţƪŝŚƣƂƷŚĩ ƀĜƯǈĩř ƾ IUGR ƱƺºųŹŚƄºƟ ŹřŵŹŚŝ ƽ Gestational Hypertensive Ŷƃ çå ƣřŶƈƯ ƾ Ƴǀ Ś ƿ ƶƘƫŚƐƯĨ į ŚƯŻōŹŚĩ ƾƿ ƫŚŝ ǀƴ ƾ řŹ ŹƺºƔƴƯƶºŝ ºſŹźŝ ƾ ŧŚºţ ǀ ź

(6)

ƺŬţ ƿ źĜſōż ƿ Ʋ íå Ư ǀƬ ƾ ŹřŵŹŚŝƲſŹŵƶƳřŻƹŹƭźĭ ƽ æç Śºţ æë ƛźƬěřŵŚŝƱŚƳŻŹŵƶŤƠƷ ǀ ŞƏź ǀƘ ƾ ůřźƏ ƾ ŵźĩ ŚºŤƳ ƿ ĩŚºůŪ ƾ Żř ƂƷŚºĩ î źººŝřźŝ ƽ ƵźºěŻƹźººŝŹŵ ƀººĜƯǈĩř ƾ ƝźƈººƯƵƹźººĭŹŵ ƵŶƴƴĩ į źĜºſō ƿ ŵƺºŝƲ çæ źºƔƳŻř ŵƹŶºŰƯ ƿ ƪºųřŵŶºƃŹŢ ººưůŹ ƾ ƹ ţƹŚººƠţŵřŻƺººƳƱŻƹ ƾ ººŝ ǀ ŵƵƹźººĭƹŵƲ ººƿ ŶƄººƳƵŶ Źŵ ƶƘƫŚƐƯ į řŚŝŚƯ ƿ ƳƹƕƹźƃƱŚƯŻƶĪƴ ºǀ ƺºŬţŻƹŵż ƿż ƽ źĜºſō ƿ Ʋ ƣřŶƈƯƶƘƫŚƐƯƶŝŚƄƯ ƾ Ƴǀ ºƫƹŵƺŝŚ ƾ ƄºŴŝ ƾ Żř ŚºŤƳ ƿ ƶºƬưūŻřŪ ƀĜƯǈĩřƵźěŻƹźŝ ƾ Ƴƹ ǀ Ưż ǀ ĮƳŚ ǀ ŵřŻƺƳƱŻƹƲ ŵƺºŝšƹŚƠŤƯ ƶºĩ Śƃ ƿ řŶ ƿ Ʋ ƝǈŤºųř ºŝ ƶ ºƠţŢºƬƗ Ś ƘƯŹŵšƹ ǀ ŚºƷŹŚ ƽ ƶºŝŵƹŹƹ ŶƃŚŝƶƘƫŚƐƯ řŹŵ ƿ ŵƶƤŝŚſƶƘƫŚƐƯƲ ƿ ƲƯżºƯƱƺºųŹŚƄºƟŢŝŚ ŝŚſ ƶƤ į ƀĜƯǈĩřƵźě ƾ ƘƯŻř ǀ ŚƷŹŚ ƽ ƤƬţźƐųźě ƾ ƶºĩŵƺŝƵŶƃ ƘƯŚŝ ǀ ŚƷŹŚ ƽ ƫŚºůŹŵŢºƃřŵšƹŚºƠţŚƯŵƹŹƹ ƾ ƶºƘƫŚƐƯƶºĩ į źƷŚƏ ƿ źĜſōƝźƈƯƶĩŵřŵƱŚƄƳƱŚ ƿ řżƟřŹŵƲ ƿ ƱřŵřŻƺƳƱŻƹƂ řŻřŚƯƶƘƫŚƐƯŚŝƶĩŢſřƵŵƺŝźŧƺƯ ƿ ƮºƷŢºƸūƲ Ƴřƺºų ƾ ŵŹřŵ çç ŚƸƳŹŵ ƿ ƯźƔƳƶŝŢ ƾ ŝƊƣŚƴţƶĩŶſŹ ǀ Ʋ řŹŚĩ ƾƿ ƝźƈƯ źĜſō ƿ ŹřŵŹŚŝƲſŹŵšƹŚƠţŢƬƗƶŝŢſřƲĪưƯƲ ƽ ƱŚºƯŻŹŵ źĜſōƕƹźƃ ƿ ƟźƈƯŻƹŵƲ ƾ źĜſō ƿ Ʋ ºƿ ƹƶºƳƺưƳśŚºŴŤƳřŹŵŚ ŶƃŚŝƶƳƺưƳƮŬů ƶŤŞƫř ƿ Ī ƾ ƶºƘƫŚƐƯƵŶºƴƴĩƁƹŶŴƯƪƯřƺƗŻř ƶĩ Śƃ ƿ ŤƳŹŵŶƳřƺŤŝŶ ǀ ŚƯŻōŹŚĩƶŬ ƾƿ ƵƺŰƳŶƃŚŝźŧƺƯ ƽ ŰƇ ǀ Ů ŵƺŝŹřŵŹŚŝŹŵŚƯƎſƺţƹŹřŵƝźƈƯ ŧŚºţƪºƯřƺƗŻřƶĩƵ ǀ ŹřŸºĭź Ư ƾ ŶƃŚŝ ŤƳ ǀ ĭƶŬ ǀ ź ƽ ƺŬţ ƿ źĜºſōż ƿ ŻƹŵŚºŝƲ íå Ư ǀ ºƬ ƾ ƭźºĭ ƶºŤƠƷŻřƶºƳřŻƹŹ į æé ŹřŵŹŚŝ ƽ ƶŝ ƱŚƳŻ Śºŝ ƿ ƶºŤƟŚ ŚºƷ ƽ ƛ ºǀ ŞƏź ǀ ºƘ ƾ źºƃźºƬěřŵ ƿ ƱŚ ưůŹ ƾ źŝŶƴģźƷ ƵźěŻƹ ƀĜƯǈĩř ƾ ŵƹŶůŚţřŹ ƽ ŶºƘţ ƿ ƪ ŵźºĩ ƫƹ ƾ ŹŚƯōƝǈŤųřŵƺūƹŢƀƳřƺŤƳ ƽ ƴƘƯ ƾ Źřŵ ƽ ĩšŚŞŧřřŹ ƹŶƴ ŚƸƳŹŵ ƿ ƯŢ ƾ ƶĩŢƠĭƱřƺţ ƿ ƶŤƟŚ ŚƷ ƽ ŢƀºƳřƺŤƳźƋŚůƂƷƹĦě źĜſōŢŞŨƯƂƤƳŻř ƿ ěŹŵƲ ǀ ĮƄ ǀź ƽ ƵźºěŻř ƀºĜƯǈĩř ƾ Śưů ºƿ Ţ Ŷƴĩ ŚºŤƳƶŝƶūƺţŚŝ ƿ ºƤƳƹŶºƋŪ ǀ ŢºŞŨƯƂºƤƳƶºŝƖºūřŹƊ źĜſō ƿ ěŹŵƲ ǀ ĮƄ ǀź ƽ ƵźěŻř ƀĜƯǈĩř ƾ ºƯźƔƳƶŝ ƾ ƭŚºŬƳřŶºſŹ ƤŰţ ǀ ţŚƤ ƾ ŬůŚŝ ƶƳƺưƳƮ į źěƱřŹŵŚƯŹŵźţǇŚŝ źƐų ƣƹŵ ƺƬ ƾƿ ƫƺƳǇŚŝƲſ ƾ ƲƯżƯƱƺųŹŚƄƟƶŝǈŤŞƯƹŹŚě ƿ ŵŚ ƿ ŢŝŚ ƠƯ ºǀ Ŷ ŢŞŨƯƂƤƳšŚŞŧřšŹƺƇŹŵŚţƵŵƺŝ źĜſō ƿ Ʋ ƱřƺŤŝ ƺŬţ ƿ řż ƿ Ʋ ƹŹřŵ řŹ ƴſŻř ǀ ŚěƲ ƿǀ ŝƲ ŹřŵŹŚ ƽ ƇƺţźƐųźěŵřźƟřŹŵ ǀ ŵźĩƶ ŶƤţ ƿ źĪƄţƹź řƿ ƄƷƹĦěŭźƏƲ ƾ ŚěƪƇŚů ƿ ƶƯŚƳƱŚ ƽ Ťſŵ ǀ ŹŚ ƽ ƈƈŴţ ƾ Ż ƯƱŚƳ ƾ ƶƳřƺŤƄºěŚºŝƶĩŶƃŚŝ ƽ ƫŚºƯ ƾ ĪºƃżěƭƺºƬƗƵŚĮƄºƳřŵ ƾ ƹżƣ ƿ ŢſřƵŶƃƭŚŬƳřƲ ºƴĤưƷ ǀ ŶºŝƲ ƿ ºſƹƲ ǀ ŹŚºĪưƷŻřƶƬ ƽ ƶƘſƺţŶůřƹ į ƤŰţ ǀ šŚƤ ŝǀ ƱŚŤſŹŚư Ƴźŧƺĩ ǀ ŶºƤţż ƿ ƪºưƗƶºŝź Ư ƾ ōƿ Ŷ References

1- World Health Organization, Make Every Mother and Child Count, World Health Report. World Health Organization, Geneva, Switzerland, 2005.

2- Confidential Enquiry into Maternal and Child Health (CEMACH), Perinatal Mortality 2006. England, Wales and Northern Ireland, CEMACH, London, UK, 2008.

3- Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009; 33:130-7. 4- Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL. Williams Obstetrics. New York 2014. 24th ed: McGraw-Hill; 728, 749.

5- Poon LC, Nicolaides KH. Early prediction of preeclampsia. Obstet Gynecol Int. 2014; 2014: 297397.

(7)

6- Maulik D. Doppler ultrasound of the umbilical artery for fetal surveillance. 2016. Available from: http://www.uptodate.com/contents/doppler-ultrasound.

7- Yu CK, Khouri O, Onwudiwe N, Spiliopoulos Y, Nicolaides KH. Prediction of pre-eclampsia by uterine artery Doppler imaging: relationship to gestational age at delivery and small-for-gestational age. Ultrasound Obstet Gynecol. 2008; 31: 310-13.

8- Prefumo F, Sebire NJ, Thilaganathan B. Decreased endovascular trophoblast invasion in first trimester pregnancies with high-resistance uterine artery doppler indices. Hum Reprod. 2004; 19: 206-09.

9- Albaiges G, Missfelder-Lobos H, Lees C, Parra M, Nico-laides KH. One stage screening for pregnancy complications by color doppler assessment of the uterine arteries at 23 weeks’gestation. Obstet Gynecol. 2000; 96: 559-64.

10- Papageorghiou AT, Yu CK, Bindra R, Nicolaides KH. Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery doppler at 23 weeks of gestation. Ultrasound Obstet Gynecal. 2001; 18: 441-49.

11- Dehghani-firouzabadiRazieh M, Saedeh A, Reza NM. Uterine artery doppler sonography in predicting preeclampsia and IUGR at 14-16 week gestation. World Appl Sci J. 2013; 22: 197-201. 12- Askie LM, Duley L, Henderson-Smart DJ,

pre-eclampsia: a meta-analysis of individual patient data. The Lancet, 2007; 369: 1791-98. 13- Bujold E, Roberge S, Lacasse Y, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010; 116: 402-14.

14- Roberge S, Villa P, Nicolaides K et al. Early administration of low-dose aspirin for the prevention of preterm and term preeclampsia: a systematic review and meta-analysis. Fetal Diagnosis and Therapy. 2012; 31: 141-46.

15- Roberge S, Giguère Y, Villa P, et al. Early administration of low-dose aspirin for the prevention of severe and mild preeclampsia: a systematic review and meta-analysis. Amer J Perinatol. 2012; 29: 551-56.

16- Ebrashy A, Ibrahim M, Marzook A, Yousef D. Usefulness of aspirin therapy in high-risk pregnant women with abnormal uterine artery doppler ultrasound at 14-16 weeks pregnancy: randomized controlled clinical trial. Croat Med J. 2005; 46: 826.

17- Harrington K, Kurdi W, Aquilina J, England P, Campbell S. A prospective management study of slow-release aspirin in the palliation of uteroplacental insufficiency predicted by uterine artery Doppler at 20 weeks. Ultasound Obstet Gynencol. 2000; 15: 13-18.

18- Grab D, Paulus WE, Erdmann M, Terinde R, Oberhoffer R, Lang D, et al. Effects of low-dose aspirin on uterine and fetal blood flow during

(8)

controlled, double-blind trial. Ultasound Obstet Gynencol. 2000; 15: 19-27.

19- Villa PM, Kajantie E, Raikkonen K, et al. Aspirin in the prevention of pre-eclampsia in high-risk women: a randomized placebo-controlled PREDO Trial and a meta-analysis of randomised trials. BJOG. 2013; 120: 64-74. 20- Bujold E, Morency AM, Roberge S, Lacasse Y, Forest JC, Giguère Y. Acetylsalicylic acid for the prevention of preeclampsia and intra-uterine growth restriction in women with abnormal

uterine artery doppler: a systematic review and meta-analysis. J Obstet Gynecal Can. 2009; 31: 818-26.

21- Mesdaghinia E, Talari H, Abedzadeh-Kalahroudi M. Effect of aspirin for prevention of preeclampsia in women with abnormal ultrasonic findings in uterine artery. Feyz. 2011; 15: 98-104.

22- Taherian AA, Taherian A, Shirvani A. Trial of aspirin and calcium on prevention of preeclampsia. J Res Med Sci 2002; 7: 136-40.

(9)

The Effect of Aspirin in the Prevention of Preeclampsia in Women withAbnormal Uterine Artery Doppler Ultrasonography Findings

Movahed F1, Lalooha F1, Moinodin R2, Dabbaghi Ghale T1, Rezaee Majd Z1, Yazdi Z3

1_{Dept. of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran} 2_{Dept. of Radiology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran} 3_{Social Determinants of Health Research Center, Qazvin Uuniversity of Medical Sciences, Qazvin,}_Iran.

Corresponding Author:Lalooha F, Dept. of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of

Medical Sciences, Qazvin, Iran E-mail: lalooha44@yahoo.com

Received: 10 Mar 2016 Accepted: 10 Jul 2016

Background and Objective: In the past three decades, the efficacy of using low dose aspirin for

preeclampsia prevention has been an important matter in obstetrics research. The purpose of this study was to determine the effectiveness of aspirin in the prevention of preeclampsia in high risk women with abnormal uterine artery Doppler ultrasonography findings.

Materials and Methods: This randomized double blind clinical trial was done in Kowsar hospital in Qazvin,

Iran in 2015. All singleton pregnant women at 11-14 weeks of gestation were evaluated by uterine artery Doppler ultrasound and in the case of abnormal findings, were divided into two groups of case (n=50) and control (n=50). The case group received aspirin 80 mg/day and the control group received daily placebos. Both groups were followed up until delivery and pregnancy outcomes including incidence of preeclampsia, intrauterine growth restriction, preterm labor, mode of delivery, 1st and 5th min Apgar score and neonatal birth weight were recorded. All these data were analyzed with T-Test and Chi-square statistical methods.

Results: Preeclampsia occurred in 6 individuals (12%) in the case group and 12 individuals (24%) in the

control group, however this reduction was not statistically significant (P=0.3). No significant difference was observed between the two groups in fetal growth restriction, preterm labor, mode of delivery and Apgar score. Average birth weight in the case group was slightly higher than the control group (P=0.05).

Conclusion: The findings of this study demonstrated that the administration of aspirin from 14 weeks of

gestation to women with abnormal Doppler ultrasonography findings could not reduce the risk of preeclampsia.