Uterine artery Doppler and biochemical markers (PAPP-A, PlGF, sFlt-1, P-selectin, NGAL) at 11+0 to 13+6 weeks in the prediction of late (>34 weeks) pre-eclampsia

Objective To determine the performance of screening for late pre-eclampsia (PE) by maternal characteristics, uterine artery Doppler and a set of biochemical markers at 11 + 0 to 13 + 6 weeks' gestation. Methods Prospectively enrolled women at 11 + 0 to 13 + 6 weeks. Maternal characteristics, highest UtA pulsatility index and serum placental biomarkers including pregnancy-associated plasma protein-A, placental growth factor, soluble fms-like tyrosine kinase 1, P-selectin and neutrophil gelatinase-associated lipocalin were recorded. Results The rate of PE was 2.5% (13/ 528). Four (0.8%) had severe PE. A combined screening model that included placental growth factor, soluble fms-like tyrosine kinase 1 and neutrophil gelatinase-associated lipocalin could detect 77% of PE at a 10% false-positive rate. Mean risk for mild PE was 8.8% +/- 6.4, mean risk for severe PE was 38.6% +/- 4.3. Mean risk for controls was 2% +/- 4.1. Conclusion This combination of maternal biochemical variables in the first trimester can detect a consistent number of late PE. Further studies on a new and independent series of data could confirm the presented results. Copyright c 2011 John Wiley & Sons, Ltd.