Document Detail


Prediction of early and late pre-eclampsia from maternal characteristics, uterine artery Doppler and markers of vasculogenesis during the first trimester of pregnancy.
MedLine Citation:
PMID:  22807133     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: The aim of this study was to develop a predictive model for preeclampsia (PET) using clinical, biochemical and ultrasound markers during the first trimester of pregnancy. Methods: This nested case-control study involved 5,367 asymptomatic pregnant women having transvaginal uterine artery Doppler (UtAD) at 11(+0) to 13(+6) weeks. Seventy pregnant women who later developed PET and 289 control patients were enrolled during the first trimester. Moreover, there were 17 pregnancies diagnosed with early- (<34 weeks) and 53 pregnancies classified as late-onset PET, respectively. The lowest (L-PI), highest and mean pulsatility indices of the UtADwere calculated. Blood samples were stored at -84 °C until biochemical analysis for vasculogenesismarkers was performed. The distributions of the L-PI of the UtAD and the biochemical markers were adjusted for maternal characteristics, expressed as multiple of the median (MoM), and compared between groups. Logistic regression analysis was used to evaluate if any variable was significantly associated with PET. Results: Pregnancies that later developed PET were associated with higher maternal body mass index (BMI). An increased L-PI of the UtAD was significantly associated with both early-and late-onset disease. The PlGFMoM was significantly reduced in women who later developed early- and late-onset PET compared to the controls (0.69 [0.33-1.46] and 1.10 [0.39-1.56] vs. 1.19 [0.65-1.84],respectively, p<0.05). Different combined models were generated by logistic regression analysis, and the DR with a fixed 10% FPR was 47% and 29% for early- and late-onset PET, respectively. Conclusion:Pregnancies that later developed early and late PET werecharacterized by impaired placentation and an anti-angiogenic state during the first trimester of pregnancy. Regression models, which include maternal characteristics, uterine artery Doppler and PlGF,can predict approximately half of those pregnancies that will be complicated by early-onset PET. In conclusion, there remain several areas of research that could aid in the creation of a better and more population-specific screening test for PET during the first trimester of pregnancy. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
M Parra-Cordero; R Rodrigo; P Barja; C Bosco; G Rencoret; A Sepúlveda-Martinez; S Quezada
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-17
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Fetal Medicine Unit, University of Chile Hospital. mcparra@redclinicauchile.cl.
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