First-Trimester Uterine Artery Pulsatility Index and Maternal Serum PAPP-A and PlGF in Prediction of Preeclampsia in Primigravida

被引：18

作者：

Salem M.A.A. ^{[1
]}

Ammar I.M.M. ^{[1
]}

机构：

[1] Department of Obstetrics and Gynecology, Faculty of medicine, Zagazig University, Zagazig

来源：

The Journal of Obstetrics and Gynecology of India | 2018年 / 68卷 / 3期

关键词：

PAPP-A; PIGF; Preeclampsia; Pulsatility index;

D O I：

10.1007/s13224-017-1012-5

中图分类号：

学科分类号：

摘要：

Background: Preeclampsia is a heterogeneous disorder affecting different body systems and frequently associated with morbidity and mortality. Early preeclampsia prediction will reduce this associated morbidity and mortality as it will give the chance for frequent maternal and fetal surveillance and application of prophylactic procedures. Objective: The aim of this work is to evaluate the role of mean pulsatility index (PI) of the uterine arteries and maternal serum concentrations of pregnancy-associated plasma protein A (PAPP-A) and placental growth factor (PlGF) in early preeclampsia prediction in primigravida. Patients and Methods: Three hundred primigravida attending the antenatal care clinic in Zagazig University Hospitals were included in the study. The mean PI of the uterine arteries was calculated. Maternal serum levels of PAPP-A and PIGF were analyzed by specific immunoassay. Results: Three hundred women were included in the final analysis, of them 30 patients (10%) suffered from preeclampsia. There was a significant difference between preeclamptic and normal women as regards the mean PI of the uterine arteries and levels of PAPP-A and PIGF at 11–13 weeks. When combining the cutoff levels of the three methods, mean PI of the uterine arteries ≥1.69, PAPP-A assay <0.96 multiple of median (MoM) and PlGF assay <0.91 MoM, the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were 56.7, 99.3, 89.5, 95.4 and 67%, respectively. Conclusion: The combined measurement of maternal serum PAPP-A and PlGF concentrations and mean PI of the uterine arteries at 11–13 weeks of pregnancy may help to predict preeclampsia in primigravida when other parameters of preeclampsia prediction are normal. However, we need more studies on larger and variable populations to evaluate the use of those combined methods in preeclampsia prediction. © 2017, Federation of Obstetric & Gynecological Societies of India.

引用

页码：192 / 196

页数：4

共 18 条

[1]

Huppertz B., Placental origins of preeclampsia: challenging the current hypothesis, Hypertension, 51, pp. 970-975, (2008)

[2]

Plasencia W., Maz N., Bonino S., Et al., Uterine artery Doppler at11 + 0 to 13 + 6 weeks in the prediction of pre-eclampsia, Ultrasound Obstet Gynecol, 30, pp. 742-749, (2007)

[3]

Nelson D., Ziadie M., Mcintire D., Et al., Placental pathology suggesting that pre-eclampsia is more than one disease, Am J Obstet Gynecol, 210, pp. 66.e1-66.e7, (2014)

[4]

Poon L.C., Nicolaides K.H., Early prediction of preeclampsia, Obstet Gynecol Int, Article ID 297397, pp. 1-11, (2014)

[5]

Patil M., Panchanadikar T.M., Wagh G., Variation of Papp-A level in the first trimester of pregnancy and its clinical outcome, J Obstet Gynaecol India, 64, 2, pp. 116-119, (2014)

[6]

Wikstrom A.K., Larsson A., Eriksson U.J., Et al., Placental growth factor and soluble FMS-like tyrosine kinase-1 in early-onset and late-onset preeclampsia, Obstet Gynecol, 109, pp. 1368-1374, (2007)

[7]

Kuc S., Wortelboer E.J., van Rijn B.B., Et al., Evaluation of 7 serum biomarkers and uterine artery Doppler ultrasound for first-trimester prediction of preeclampsia: a systematic review, Obstet Gynecol Surv, 66, 4, pp. 225-239, (2011)

[8]

Steegers E.A.P., Dadelzsen P.V., Duvekot J.J., Et al., Preeclampsia, Lancet, 376, pp. 631-644, (2010)

[9]

Lees C., First-trimester screening for pre-eclampsia and fetal growth restriction: a test seeking both a treatment and an optimal timing, Ultrasound Obstet Gynecol, 35, pp. 647-649, (2010)

[10]

Cnossen J.S., Morris R.K., ter Riet G., Et al., Use of uterine artery Doppler ultrasonography to predict preeclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis, CMAJ, 178, (2008)

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