Prediction of preeclampsia using a combination of serum micro RNA-210 and uterine artery Doppler ultrasound

Abstract

The objective was to determine whether a combination of serum micro RNA-210 level and uterine artery Doppler can predict preeclampsia in pregnant women at 16–24 weeks gestation. A prospective observational study conducted in singleton pregnant women at 16–24 weeks of gestation who had prenatal care at the King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand between 2017 and 2018. Uterine artery Doppler ultrasound and blood testing for serum micro RNA-210 were performed. Pregnancy outcomes were recorded. Optimal cut-off for uterine artery pulsatility index (PI) and serum micro RNA-210 were obtained to calculate the predictive values for preeclampsia. Data from 443 participants were analyzed. Twenty-two cases developed preeclampsia (5.0%) and seven of these preeclamptic cases had early-onset preeclampsia (1.6%). Pregnant women with preeclampsia had higher mean PI of the uterine artery (1.34 ± 0.52 vs 0.98 ± 0.28, p = 0.004), higher detection rates of diastolic notching (45.5% vs 11.2%, p < 0.001), and lower median serum micro RNA-210 level (22.86 vs 795.78, p < 0.001) than pregnant women without preeclampsia. Using abnormal serum micro RNA-210 level, abnormal mean PI or uterine artery diastolic notches to predict for preeclampsia, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 95.5%, 54.9%, 10.0%, and 99.6%, respectively. For early-onset preeclampsia prediction, the sensitivity, specificity, PPV, and NPV were 100.0%, 53.2%, 3.3%, and 100.0%, respectively. This study demonstrated that a combination of serum micro RNA-210 and uterine artery Doppler is effective in predicting preeclampsia in the second trimester.

A Second Trimester Prediction Algorithm for Early-Onset Hypertensive Disorders of Pregnancy Occurrence and Severity Based on Soluble fms-like Tyrosine Kinase 1 (sFlt-1)/Placental Growth Factor (PlGF) Ratio and Uterine Doppler Ultrasound in Women at Risk

“…We reported higher mean uterine PI values in the cases of women who later developed preeclampsia and also higher control values (1.5 ± 0.13 vs. 1.12 ± 0.13), keeping the difference between them significant. Additionally, Trongpisutsak [34] also obtained increased mean uterine PI values at 16-24 weeks of gestation in the case of pregnancies later affected by preeclampsia (1.34 ± 0.52 vs. 0.98 ± 0.28 for control, p = 0.004)-the same mean value as the one reported by Adekanmi-and established the best cutoff value for mean uterine PI at 1.025. Abdel Razik [17] considered the 20-24 weeks Doppler scan as one of the finest predictors of preeclampsia, establishing 1.14 as the mean uterine artery PI cutoff for preeclampsia prediction, which is slightly lower than our cutoff (1.25).…”

“…Consequently, PubMed displays more than 10,000 research papers regarding screening strategies for preeclampsia. Some studies have focused on preeclampsia prediction using sFlt-1/PlGF ratio values in the first, second or third trimester [23][24][25][26][27][28][29][30][31][32], while other papers have concentrated on uterine Doppler scan as a predictor of HDPs [33][34][35][36][37][38]. Finally, we discovered two articles which focused on preeclampsia screening using a combination of sFlt-1/PlGF ratio with uterine Doppler ultrasound parameters [39,40].…”

The Current Role of the sFlt-1/PlGF Ratio and the Uterine–Umbilical–Cerebral Doppler Ultrasound in Predicting and Monitoring Hypertensive Disorders of Pregnancy: An Update with a Review of the Literature

“…As for predicting the severe form of pre-eclampsia, the combination of mean uterine PSV and mean umbilical PSV showed a positive predictive value of 80.3% (AUC = 0.8, p = 0.002). In addition, Trongpisutsak [ 54 ] found increased mean uterine PI at 16–24 weeks of gestation among patients who later developed pre-eclampsia (1.34 ± 0.52 vs. 0.98 ± 0.28 for control, p = 0.004)—the optimal cut-off value for mean uterine PI was 1.025—as well as higher prevalence of diastolic notching (45.5% vs. 11.2% for control, p < 0.001).…”