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

Prenat Diagn. 2011 Dec;31(12):1141-6. doi: 10.1002/pd.2848. Epub 2011 Oct 28.

Abstract

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.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute-Phase Proteins
  • Adult
  • Biomarkers / blood*
  • Female
  • Forecasting
  • Humans
  • Lipocalin-2
  • Lipocalins / blood
  • Mass Screening
  • Membrane Proteins / blood
  • P-Selectin / blood
  • Pre-Eclampsia / blood
  • Pre-Eclampsia / diagnostic imaging*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Trimester, First
  • Pregnancy Trimester, Third
  • Pregnancy-Associated Plasma Protein-A / metabolism
  • Prospective Studies
  • Proto-Oncogene Proteins / blood
  • Ultrasonography, Doppler, Pulsed
  • Uterine Artery / diagnostic imaging
  • Vascular Endothelial Growth Factor Receptor-1 / blood

Substances

  • Acute-Phase Proteins
  • Biomarkers
  • LCN2 protein, human
  • Lipocalin-2
  • Lipocalins
  • Membrane Proteins
  • P-Selectin
  • PIGF protein, human
  • Proto-Oncogene Proteins
  • FLT1 protein, human
  • Vascular Endothelial Growth Factor Receptor-1
  • Pregnancy-Associated Plasma Protein-A