Predictive value of angiogenic factors and uterine artery Doppler for early- versus late-onset pre-eclampsia and intrauterine growth restriction.
OBJECTIVE
To investigate potential differences in the prediction of early- vs. late-onset pre-eclampsia and/or intrauterine growth restriction (PE/IUGR) by second-trimester uterine artery Doppler examination, and measurement of maternal serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt1).


METHODS
Uterine artery mean pulsatility index (PI) and maternal serum PlGF and sFlt1 levels were measured at 24 weeks of gestation in 76 healthy pregnant women and 38 cases of PE/IUGR, of which 19 were defined as early onset (< 32 weeks).


RESULTS
For a specificity of 95%, the sensitivities of uterine artery mean PI, PlGF and sFlt1 for early-onset PE/IUGR were 47.4%, 84.4% and 36.8%, respectively. When combining uterine artery Doppler with PlGF, the sensitivity for identifying early-onset PE/IUGR was 89.5% with a specificity of 95%. Conversely, the sensitivity for late-onset PE/IUGR was below 11% for all parameters analyzed.


CONCLUSIONS
Angiogenic factors and uterine artery Doppler evaluation may be useful second-trimester screening tests for early-onset, but not late-onset, PE/IUGR.
Department of Obstetrics, Fetal Medicine Unit, Barcelona, Spain.
F
F
Crispi
E
E
Llurba
C
C
Domínguez
P
P
Martín-Gallán
L
L
Cabero
E
E
Gratacós
D000328:Adult; D000704:Analysis of Variance; D042501:Angiogenic Proteins / Q000097:blood*; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D000072483:Placenta Growth Factor; D021041:Placental Circulation; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D018608:Ultrasonography, Doppler / Q000379:methods*; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014599:Uterus / Q000098:blood supply / Q000000981:diagnostic imaging*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood
D042501:Angiogenic Proteins; D015415:Biomarkers; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1