Values of Certain Clinical and Biochemical Tests for Prediction of Pre-Eclampsia

Abstract

To evaluate different predictive tests for pre-eclampsia, either individually or in combination, we prospectively studied 100 primigravid females. Eighty-eight of the subjects continued the follow-up until delivery and 17 developed pre-eclampsia. Venous blood samples were taken for determination of plasma fibronectin, and urine samples were taken for determination of microalbuminuria and calcium-creatinine ratio. Isometric handgrip exercise tests were also performed. Evaluation of predictive tests, as well as t and chi-squared statistical tests, were used for analysis of data. Pre-eclampsia developed in 19.3% of the patients studied. Pre-eclamptic and normotensive females showed significant differences in calcium-creatinine ratio and plasma fibronectin levels in both (14-24 weeks and 28-32 weeks) gestation periods (P<.0001). Plasma fibronectin had the best sensitivity, positive, and negative values in gestation period 14-24 weeks, whereas isometric handgrip exercise tests had the best specificity. These values improved for all the tests in the 28-32-week gestation period; even so, plasma fibronectin proved best of all. A combination of tests failed to improve the predictive ability of fibronectin alone. We conclude that plasma fibronectin is the best predictive test for pre-eclampsia.

Persistant pre-eclampsia post partum with elevated liver enzymes and hemolytic uremic syndrome

“…Plasma fibronectin had the best sensitivities as a predictive test for pre-eclampsia, where 17 of 88 subjects developed this syndrome [70]. Such early recognition may allow prevention of this "precursor" to HELLP, AFLP, and HUS.…”