Prediction of Preeclampsia by Uterine Artery Doppler Examination and Placental Growth Factor, Endoglin and Pregnancy-associated Plasma Protein Levels in Maternal Serum at 11-13+6 Pregnancy Week

Abstract

Objective: We aimed to evaluate the prediction of preeclampsia by maternal serum pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PIGF),sEndoglin (sEng) and uterine artery Doppler examination.Methods: One hundred and ninety-three singleton pregnant women admitted to outpatient clinic at 11-13+6 weeks for first trimester combined screening test wereincluded in the study. Maternal history was taken, and uterine artery Doppler examination and serum biomarker screening (PAPP-A, PIGF, sEndoglin) were conducted.The follow-up results of pregnancy were recorded. The study cohort was divided into two groups as “control” and “preeclampsia”. Mann-Whitney U and chi-square testswere used for comparison of independent variables. Sensitivity and specificity for the predictive values of the significant parameters were calculated from ROC curves.Results: Of 193 women, 168 women (87%) were in the control group (group 1) and 25 women (12.9%) who developed preeclampsia were defined in the preeclampsiagroup. In preeclampsia group, 20 women (10.3%) with gestational hypertension and mild preeclampsia were defined as “group 2”, and five women (2.5%) with severepreeclampsia and hemolysis, elevated liver enzymes, low platelet were defined as “group 3”. Maternal serum PAPP-A, PIGF, sEng levels were not significantly differentbetween preeclampsia group and control group, whereas uterine artery Doppler pulsatility index (PI) values were significantly higher in preeclampsia group (p=0.023).sEng levels were significantly higher in group 3 than those in group 2 (p=0.001). If uterine artery PI cut-off level was taken as >2.23 in ROC curve analysis, sensitivitywas 42.31% and specificity was 82.10% for detecting preeclampsia.Conclusion: Maternal serum PAPP-A, PIGF and sEng were not effective in predicting preeclampsia. However, these markers can be used to distinguish between mild andsevere preeclampsia. First trimester uterine artery Doppler examination is an effective screening method for predicting preeclampsia.