Circulatory soluble endoglin and its predictive value for preeclampsia in second-trimester pregnancies with abnormal uterine perfusion.
OBJECTIVE
Soluble endoglin (sEng) is increased dramatically in preeclampsia and acts synergistically with soluble fms-like tyrosine kinase 1 (sFlt1) to promote the preeclamptic phenotype. The aim of this study was to investigate whether the sEng increase was present already in second-trimester pregnancies with abnormal uterine perfusion and whether the pregnancy was at risk for preeclampsia.


METHODS
This prospective study includes 77 second-trimester pregnant women with abnormal uterine perfusion. sEng and sFlt1 were measured with an enzyme-linked immunosorbent assay.


RESULTS
Adverse pregnancy outcome was associated with higher sEng levels in the second trimester. SEng was highest in those pregnancies with early-onset preeclampsia. Combined analysis of sEng and sFlt1 is able to predict early-onset preeclampsia with a sensitivity of 100% and a specificity of 93.3%.


CONCLUSIONS
Elevated sEng levels are detectable in second-trimester pregnancies with abnormal uterine perfusion and subsequent pregnancy complications. The concurrent measurement of uterine perfusion and angiogenic factors allows a highly efficient prediction of early-onset preeclampsia.
Stepan
Holger
H
Department of Obstetrics and Gynecology, University of Leipzig Faculty of Medicine, Leipzig, Germany. holger.stepan@medizin.uni-leipzig.de
Geipel
Annegret
A
Schwarz
Friederike
F
Krämer
Thomas
T
Wessel
Niels
N
Faber
Renaldo
R
D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000097:blood*; D001158:Arteries / Q000502:physiology; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D000071063:Endoglin; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D011673:Pulsatile Flow; D012372:ROC Curve; D011956:Receptors, Cell Surface / Q000097:blood*; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply / Q000000981:diagnostic imaging
D015703:Antigens, CD; D015415:Biomarkers; C064206:ENG protein, human; D000071063:Endoglin; D011956:Receptors, Cell Surface