Does the Addition of Serum PAPP-A and β-hCG Improve the Predictive Value of Uterine Artery Pulsatility Index for Preeclampsia at 11–14 Weeks of Gestation? A Prospective Observational Study

Khanam, Zeba; Mittal, Pratima; Suri, Jyotsna

doi:10.1007/s13224-020-01420-7

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…This discrepancy highlights the subtle nature of these indices in differentiating between gestational hypertension and preeclampsia, underscoring the critical need for tailored screening protocols. Comparative analysis with previous studies, such as those by Khanam et al [ 9 ], reveals higher sensitivity in our study for detecting preeclampsia using mean PI. This discrepancy points to the evolving understanding and application of these indices in prenatal screening.…”

Section: Discussionsupporting

confidence: 68%

“…The studies conducted by Khanam et al, as well as Shahid et al [ 9 , 18 ], provide a contextual backdrop for our findings. The ROC AUC values reported in these studies underscore the predictive accuracy of uterine artery PI in the screening for gestational hypertension and preeclampsia.…”

Section: Discussionsupporting

confidence: 55%

“…Based on the research conducted by Khanam et al [ 9 ], which provided the specificity of the uterine artery Pulsatility Index (PI) color Doppler ultrasound as 98.9%, with a precision of 2.25% and a 95% confidence interval, the sample size was calculated using the formula: N = Z²×Sp×(1-Sp)/d²(1-p).…”

Section: Methodsmentioning

confidence: 99%

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Role of Uterine Artery Doppler Study Between 11 and 14 Weeks as a Predictor of Preeclampsia

RK,

Ramakrishnan,

Gunasekaran

et al. 2024

Cureus

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Introduction Preeclampsia is a serious complication marked by antepartum hemorrhage, resulting in severe maternal and fetal complications. Predicting this condition using placental dysfunction assessments, such as uterine artery Doppler ultrasound, is challenging due to the placenta's evolving structural and biochemical characteristics throughout different stages of pregnancy. Objectives To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the uterine artery Doppler Pulsatility Index (PI) and Resistive Index (RI) in predicting preeclampsia. To compare the Doppler ultrasound measurements between normal pregnancies and those that develop preeclampsia. To assess the diagnostic accuracy of uterine artery Doppler ultrasound in predicting gestational hypertension in addition to preeclampsia. Methodology Conducted as a prospective study, 116 antenatal mothers with computed gestational ages and scan gestational ages between 11 and 14 weeks, and a previous history of preeclampsia were included. Subjects with chronic hypertension or multiple gestations were excluded. Participants underwent uterine artery Doppler screening, during which the PI and RI were measured upon obtaining three consecutive similar waveforms, and the mean PI of the left and right arteries was calculated. The outcomes of patients with normal pregnancies and those who developed preeclampsia were compared. Data were entered into Microsoft Excel (Microsoft® Corp., Redmond, WA, USA) and analyzed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, NY, USA). Results The mean PI among participants was 1.75 (±0.38), with a range from 1 to 2.75. The mean RI was 0.58 (±0.08), ranging from 0.45 to 0.8. The cutoff for the mean PI in predicting preeclampsia was 2.27, which showed a sensitivity of 92.9%, specificity of 97.1%, PPV of 81.47%, NPV of 99.01%, and a diagnostic accuracy of 96.59% (area under the curve (AUC): 0.982). The cutoff for the mean RI for predicting preeclampsia was 0.695, with a sensitivity of 85.7%, specificity of 98%, PPV of 85.47%, NPV of 98.04%, and diagnostic accuracy of 96.52% (AUC: 0.965). In predicting gestational hypertension, the cutoff for the mean PI was 1.975, with a sensitivity of 80%, specificity of 82.9%, PPV of 17.41%, NPV of 98.92%, and diagnostic accuracy of 82.78% (AUC: 0.848). The cutoff for the mean RI in predicting gestational hypertension was 0.615, showing a sensitivity of 80%, specificity of 80.2%, PPV of 15.4%, NPV of 98.89%, and diagnostic accuracy of 80.19% (AUC: 0.767). Conclusion The research demonstrated that aberrant readings in uterine Doppler ultrasound, specifically in the PI and RI, possess strong overall validity in forecasting the occurrence of preeclampsia.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionsupporting

confidence: 55%

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Role of Uterine Artery Doppler Study Between 11 and 14 Weeks as a Predictor of Preeclampsia

RK,

Ramakrishnan,

Gunasekaran

et al. 2024

Cureus

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“…The findings revealed that UtA-PI was an effective biomarker for screening hypertension and preeclampsia and that the inclusion of PAPP-A and β-hCG did not enhance the predictive value for these conditions. As such, the addition of PAPP-A and β-hCG to UtA-PI was not recommended for routine screening [47]. However, the study had the limitation of having a relatively small sample.…”

Section: Resultsmentioning

confidence: 99%

Role of First Trimester Screening Biochemical Markers to Predict Hypertensive Pregnancy Disorders and SGA Neonates—A Narrative Review

Górczewski,

Górecka,

Massalska-Wolska

et al. 2023

Healthcare

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Early recognition of high-risk pregnancies through biochemical markers may promote antenatal surveillance, resulting in improved pregnancy outcomes. The goal of this study is to evaluate the possibilities of using biochemical markers during the first trimester of pregnancy in the prediction of hypertensive pregnancy disorders (HPD) and the delivery of small-for-gestational-age (SGA) neonates. A comprehensive search was conducted on key databases, including PubMed, Scopus, and Web of Science, for articles relating to the use of biochemical markers in the prediction of HPD and SGA. The findings show that changes in the levels of biomarkers in the early pregnancy phases could be an important indicator of adverse pregnancy outcomes. The literature shows that low PAPP-A (pregnancy-associated plasma protein A) and PlGF (placental growth factor) levels, low alkaline phosphatase (AP), higher sFlt-1 (soluble fms-like Tyrosine Kinase-1) levels, higher AFP (alfa fetoprotein) levels, and elevated levels of inflammatory markers such as β-HGC (free beta human chorionic gonadotropin), interferon-gamma (INF-γ), and tumor necrosis factor-α (TNF-α) may be associated with risks including the onset of HPD, fetal growth restriction (FGR), and delivery of SGA neonates. Comparatively, PAPP-A and PlGF appear to be the most important biochemical markers for the prediction of SGA and HPD.

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Uterine arteries pulsatility index by Doppler ultrasound in the prediction of preeclampsia: an updated systematic review and meta-analysis

Liu,

Xie,

Huang

et al. 2023

Arch Gynecol Obstet

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Does the Addition of Serum PAPP-A and β-hCG Improve the Predictive Value of Uterine Artery Pulsatility Index for Preeclampsia at 11–14 Weeks of Gestation? A Prospective Observational Study

Cited by 6 publications

References 29 publications

Role of Uterine Artery Doppler Study Between 11 and 14 Weeks as a Predictor of Preeclampsia

Role of Uterine Artery Doppler Study Between 11 and 14 Weeks as a Predictor of Preeclampsia

Role of First Trimester Screening Biochemical Markers to Predict Hypertensive Pregnancy Disorders and SGA Neonates—A Narrative Review

Uterine arteries pulsatility index by Doppler ultrasound in the prediction of preeclampsia: an updated systematic review and meta-analysis

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