Year: 2008
Type: conference-abstract
Abstract: First trimester uterine artery Doppler alone has not proved clinically useful in predicting PE. First trimester PP13 is significantly lower in women who subsequently develop the disease. In the non-pregnant population, pulse wave analysis can be used as a predictive tool in cardiovascular disorders. Vascular changes that precede the clinical diagnosis of PE can be detected by this technique. The objective of this study was to evaluate whether a combination of uterine artery Doppler, maternal serum placental protein 13 (PP13) and pulse wave analysis at 11 to 13 weeks' gestation can predict pre-eclampsia (PE). A nested case-control study of women who developed PE. Controls were matched for gestational age and storage time of the maternal serum. At 11 to 13 weeks, we measured uterine artery Doppler mean pulsatility index (PI), pulse wave analysis augmentation index at heart rate of 75/min (AIx-75), and PP13 using a specific ELISA. Logistic regression models were developed and their predictive accuracy assessed using the area under the receiver operator curve (AROC). 42 women who developed PE (14 early-onset, i.e < 34 weeks' gestation), and 210 matched controls were included. All markers (mean PI, PP13 and AIx-75) were significantly lower in cases compared with controls (P < 0.001). ROC analysis for all cases of pre-eclampsia compared with controls yielded AROC of 0.72 (95%CI: 0.65–0.8) for mean PI, 0.8 (0.67–0.91) for PP13 MoMs, and 0.92 (0.87–0.96) for AIx-75. The equivalent AROC values for early-onset PE were 0.78 (0.66–0.89), 0.87 (0.81–0.93), and 0.94 (0.9–0.99) respectively. The combination of first trimester uterine artery Doppler, PP13 and pulse wave analysis can provide a clinically useful predictive tool for pre-eclampsia. Identifying at risk women early in pregnancy is an essential step in the development of an effective preventative measure.
DOI: 10.1002/uog.5721
Institutions: Queen Mary University of London, King George Hospital
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2037660464