title: Screening test for preeclampsia through assessment of uteroplacental blood flow and biochemical markers of oxidative stress and endothelial dysfunction.
abstract: OBJECTIVE
  This study was undertaken to evaluate whether screening through a uterine artery (UtA) Doppler and biochemical markers of oxidative stress and endothelial dysfunction predict preeclampsia.
  
  
  METHODS
  UtA Doppler was performed at 11 to 14 and 22 to 25 weeks on 1447 asymptomatic pregnant women. Oxidative stress, endothelial dysfunction, and antiangiogenic state were assessed in women who later developed preeclampsia and normotensive controls.
  
  
  RESULTS
  There was a significantly increased of UtA pulsatility index (PI), plasma levels of soluble fms-like tyrosine kinase 1 (sFlt1), PAI-1/PAI-2 ratio, and F-2 isoprostane in women who subsequently developed preeclampsia compared with control pregnancies. Multivariate logistic regression showed that increased UtA PI performed at 23 weeks was the best predictor for preeclampsia.
  
  
  CONCLUSIONS
  This study demonstrates early changes in markers of impaired placentation, antiangiogenic state, oxidative stress, and endothelial dysfunction suggesting that these derangements may play a role in the pathogenesis of preeclampsia. Our data point to UtA as the best test to predict preeclampsia at 23 weeks of gestation.
authors.affiliation: Fetal Medicine Unit, Hospital Clínico Universidad de Chile, Santiago, Chile. mcparra@ns.hospital.uchile.cl
authors.forename: Mauro
authors.initials: M
authors.lastname: Parra
authors.forename: Ramón
authors.initials: R
authors.lastname: Rodrigo
authors.forename: Pilar
authors.initials: P
authors.lastname: Barja
authors.forename: Cleofina
authors.initials: C
authors.lastname: Bosco
authors.forename: Virginia
authors.initials: V
authors.lastname: Fernández
authors.forename: Hernán
authors.initials: H
authors.lastname: Muñoz
authors.forename: Emiliano
authors.initials: E
authors.lastname: Soto-Chacón
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D004730:Endothelium, Vascular; D005260:Female; D006801:Humans; D008403:Mass Screening; D018384:Oxidative Stress; D010920:Placenta / Q000098:blood supply*; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis*; D011247:Pregnancy; D012039:Regional Blood Flow; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging*
chemical_list: D015415:Biomarkers