Evaluation of First Trimester Uterine Artery Doppler, Placental Growth Factor and Maternal Characteristics in Prediction of Preeclampsia

Abstract

Background: Preeclampsia is a major contributor of maternal and perinatal morbidity and mortality. The purpose of this study was to look at the predictive usefulness of placental growth factor (PLGF), maternal characteristics (MC), and uterine artery Doppler for preeclampsia in the first trimester. Patients and methods: A cross-sectional survey was conducted on 805 pregnant women between 11 + 0 and 13 + 6 weeks' gestation. A complete history and clinical examination were taken at the booking visit, a bilateral uterine artery Doppler study was estimated, and the mean pulse index (PI) was computed and recorded. A venous blood sample was drawn and centrifuged for 10 minutes at 3000 rpm to extract the serum, which was then frozen at 80 C for further examination for placental growth factor (PLGF). Results: PE developed in 54 (6.7%) cases; 11 (20.4%) early-onset and 43 (79.6%) late-onset. The following parameters were calculated: sensitivity, specificity, positive and negative value (PPV and NPV), and accuracy. The sensitivities for MC, PLGF and UADPI for prediction of early-onset preeclampsia were 27.3%, 54.5%, and 72.7%, respectively. The sensitivities for MC, PLGF and UADPI for prediction of late-onset preeclampsia were 14%, 55.8%, and 51.2%, respectively. The sensitivity for combination between the three factors used to predict PE were 85.7% for early-onset and 79.4% for late-onset preeclampsia, respectively. Conclusions: Effective screening for PE may be accomplished in the first trimester of pregnancy, at 11-14 weeks' gestation, by combining maternal features with the findings of uterine artery Doppler and placental growth factor to determine the risk of PE development.

First trimester prediction for preeclampsia using maternal characteristics, placental growth factor and estimated placental volume

“…In this study, females with preeclampsia have statistically significant lower PlGF than females without preeclampsia. This is in accordance with Negm et al [10] who reported that, Patients with PE had reduced maternal PLGF levels than women in the control group when the study groups' levels were examined. This is consistent with Mosimann et al [12] , who investigated the value of repeating first trimester PLGF in PE screening as well as the importance of timing it.…”

“…Regarding parity and the method of labour, there was no significant difference in this study between the preeclamptic and non-preeclamptic females. This agrees with Negm et al [10] He said that there were no significant differences in mean number of deliveries or parity between the research's examined groups. This contradicts the results of Kashanian et al [11] who examined the risk factors for preeclampsia and found that having more than one child is a significant protective factor against preeclampsia.…”

“…The test's accuracy increased much more when it was performed at or after 19 weeks. This disagrees with Negm et al [10] who reported that In terms of predicting early and late PE, PLGF's sensitivity was 43% and 37% and its specificity was 91% and 89%, respectively. Combined PLGF and Uterine Artery Doppler pulse index (UADPI) in their study proved to be 65.5% sensitivity, 98.8% specificity, 33.3% PPV and 93.5% NPV value.…”