Screening test for preeclampsia through assessment of uteroplacental blood flow and biochemical markers of oxidative stress and endothelial dysfunction.
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.
Parra
Mauro
M
Fetal Medicine Unit, Hospital Clínico Universidad de Chile, Santiago, Chile. mcparra@ns.hospital.uchile.cl
Rodrigo
Ramón
R
Barja
Pilar
P
Bosco
Cleofina
C
Fernández
Virginia
V
Muñoz
Hernán
H
Soto-Chacón
Emiliano
E
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*
D015415:Biomarkers