title: Factor II: C activity and uterine artery Doppler evaluation to improve the early prediction of pre-eclampsia on women with gestational hypertension.
abstract: 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.
authors.affiliation: Department of Pediatric, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Florio
authors.forename: Gemma
authors.initials: G
authors.lastname: D'Aniello
authors.forename: Laura
authors.initials: L
authors.lastname: Sabatini
authors.forename: Filiberto M
authors.initials: FM
authors.lastname: Severi
authors.forename: Daniela
authors.initials: D
authors.lastname: Fineschi
authors.forename: Caterina
authors.initials: C
authors.lastname: Bocchi
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Reis
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: 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
chemical_list: D015415:Biomarkers; D014841:von Willebrand Factor; D011516:Prothrombin