Risk assessment for preeclampsia by biochemical and biophisycal markers at first trimester
- VernacularTitle: Манас таталтын урьдлаар хүндрэх эрсдэлийг жирэмсний эхний гурван сард үнэлсэн нь
- Author:
Urjindelger Ts
1
;
Ariunbold Ch
2
;
Munkhtsetseg J
2
;
Erkhembaatar T
3
Author Information
1. National Center for Maternal and Child Health
2. Mongolian National University of Medical Sciences, School of Pharmacy and Biomedicine
3. School of Medicine
- Publication Type:Journal Article
- Keywords:
Mean arterial Pressure;
Placental growth factor (PlGF);
Pregnancy-associated plasma protein A (PAPP-A);
preeclampsia;
Uterine artery pulsatility index
- From:Mongolian Medical Sciences
2017;181(3):30-38
- CountryMongolia
- Language:Mongolian
-
Abstract:
Introduction:Preeclampsia, which affects about 2-8% of pregnancies, is major cause of maternal and perinatal
morbidity and mortality, particularly in developing countries. In Mongolia, preeclampsia and eclampsia
occurred among pregnancy complications about 25% in recent years. There is a percentage for a
cause of maternal death was 17.7% in preeclampsia and eclampsia between 2012 and 2015 in
Mongolia.
Effective prediction of preeclampsia can be achieved at 11-13 week’s gestation by combination
of maternal characteristics, mean arterial pressure (MAP), uterine artery pulsatility index (UtA
PI), maternal serum placental growth factor (PlGF), and pregnancy-associated plasma protein-A
(PAPP-A).
Goal:To investigate plasma concentration of PIGF and PAPP-A, in pregnant women at 11-13+6 of
gestation for screening of preeclampsia, To examine the performance of first-trimester screening for
preeclampsia based on maternal characteristics, MAP, and mUt.A-PI.
Materials and Methods :The study conducted among 393 single pregnant women at 11-13+6 weeks, who were visiting
antenatal care services, between March, 2015 and June, 2017. The prospective Cohort research
method was used for this study. Written informed consent was obtained from all participants.
Maternal plasma PAPP-A, PlGF were determined using Perkin Elmer kits by fluoroimmunoassay.
Measurement of MAP was by validated automated devices (HEM-7120, Оmron, Japan). MAP was
calculated from the formula DP + 1/3*(SP-DP), where DP represents diastolic blood pressure and
SP- systolic blood pressure. Trans-abdominal ultrasound (Voluson E8, GE, USA) examination was
carried out for Ut.A-PI.
Results:In the study population, there were 66 (16.8%) cases that experienced preeclampsia and 327
(83.2%) cases that were unaffected by preeclampsia.
The result showed that the mean concentration of PlGF was 38.6±19.6 pg/ml in PE group whereas
the mean was 45.1±24.0 pg/ml in normal pregnant women. Level of PAPP-A was 366.1±195.3 mU/L
in group with PE, 633.6±496.9 mU/L in group without preeclampsia.
The best Youden’s index and area under the curve (AUC) for MAP and mUt.A-PI were as a
predictor of PE. It can be shown that the cutoff point for MAP was 89.5 mmHg (sensitivity-71.2%;
specificity-75.5% J-0.467; AUC-0.792; P<0.001). The cutoff point of mUt.A-PI was 2.34
(sensitivity-33.3%; specificity-77.7% J-0.12; AUC-0.577; P<0.001).
Conclusions:The concentration of PIGF and PAPP-A in pregnant women with preeclampsia at 11-13+6 of gestation
was lower than normal pregnant women. The detection risk of PE by MAP is more accurate than the
mUtA-PI measurement.
- Full text:2017-181(3)-30-38.pdf
