Factor II: C activity and uterine artery Doppler evaluation to improve the early prediction of pre-eclampsia on women with gestational hypertension.
OBJECTIVE
To evaluate whether the determination of maternal plasma Factor II:C (FII:C) and mean uterine artery resistance index may be useful to early predict pre-eclampsia in patients with gestational hypertension.


METHODS
Prospective study.


METHODS
Consecutive enrollment in a public tertiary clinical care centre.


METHODS
A total of 65 women with gestational hypertension at 24-26 weeks.


METHODS
Measurements of maternal plasma FII:C activity levels, ultrasonographic biometrical parameters and Doppler velocimetry of maternal uterine arteries.


METHODS
The probability of developing pre-eclampsia was the main outcome of the study and it was computed by combining the FII:C and the mean uterine artery resistance index cut-off points, chosen by receiver operating characteristic (ROC) curve analysis.


RESULTS
F-II:C activity levels and mean uterine artery resistance index were significantly (both P < 0.01) higher in women who developed pre-eclampsia. A weak, but significant correlation (r = 0.3, P < 0.05) was found between these two parameters. FII:C activity levels at the cut-off value of 136.5% achieved a sensitivity of 61.1% and a specificity of 71.3%, while mean uterine artery resistance index (RI) at the cut-off value of 0.57 showed a sensitivity of 85.7% and a specificity of 90.2% in predicting the onset of pre-eclampsia. When both FII:C and mean uterine RI were over the cut-off points the positive predictive value was of 89%, with a 100% negative predictive value when both were below the cut-off points.


CONCLUSIONS
F-II:C activity levels and mean uterine artery resistance index determination at mid trimester may improve the prediction of superimposed pre-eclampsia on women with early onset gestational hypertension.
Florio
Pasquale
P
Department of Pediatric, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.
D'Aniello
Gemma
G
Sabatini
Laura
L
Severi
Filiberto M
FM
Fineschi
Daniela
D
Bocchi
Caterina
C
Reis
Fernando M
FM
Petraglia
Felice
F
D000328:Adult; D015415:Biomarkers; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D011516:Prothrombin / Q000378:metabolism*; D012372:ROC Curve; D012307:Risk Factors; D018608:Ultrasonography, Doppler; D014599:Uterus / Q000098:blood supply*; D014841:von Willebrand Factor
D015415:Biomarkers; D014841:von Willebrand Factor; D011516:Prothrombin