Document Detail


Hypertensive disorders in pregnancy: combined screening by uterine artery Doppler, blood pressure and serum PAPP-A at 11-13 weeks.
MedLine Citation:
PMID:  20108221     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To explore if the addition of pregnancy-associated plasma protein-A (PAPP-A) to maternal factors and biophysical markers yields a significant improvement in the detection of hypertensive disorders before the clinical onset of disease. METHODS: Prospective screening study for early preeclampsia (PE), late PE and gestational hypertension (GH) in women attending their first hospital visit at 11(+0)-13(+6) weeks of gestation. The performance of screening for PE and GH by combinations of maternal factors, uterine artery with the lowest pulsatility index (L-PI), mean arterial pressure (MAP) and serum PAPP-A was determined. RESULTS: There were 8061 unaffected controls, 37 of whom developed early PE, 128 with late PE and 140 with GH. Compared to the controls, in early PE and late PE MAP and uterine artery L-PI were increased and PAPP-A was decreased. In GH PAPP-A was not significantly different from controls. In screening for a combination of maternal factors, uterine artery L-PI, MAP and PAPP-A the detection rate of early PE was 83.8%, at a 5% false-positive rate. In the prediction of late PE and GH there was no significant improvement from the addition of PAPP-A to the combination of maternal factors, MAP and uterine artery L-PI. CONCLUSION: Measurement of PAPP-A improves the performance of screening for early PE provided by a combination of maternal factors and biophysical tests at 11-13 weeks.
Authors:
Leona C Y Poon; Violeta Stratieva; Silvia Piras; Solmaz Piri; Kypros H Nicolaides
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  30     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-06-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  216-23     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 John Wiley & Sons, Ltd.
Affiliation:
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure / physiology*
False Positive Reactions
Female
Gestational Age
Great Britain / epidemiology
Humans
Mass Screening / methods*
Pre-Eclampsia / blood,  diagnosis*,  ultrasonography
Pregnancy
Pregnancy Trimester, First / blood
Pregnancy-Associated Plasma Protein-A / analysis*
Prospective Studies
Pulsatile Flow / physiology
Ultrasonography, Doppler
Uterine Artery / ultrasonography*
Chemical
Reg. No./Substance:
EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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