title: Circulatory soluble endoglin and its predictive value for preeclampsia in second-trimester pregnancies with abnormal uterine perfusion.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Leipzig Faculty of Medicine, Leipzig, Germany. holger.stepan@medizin.uni-leipzig.de
authors.forename: Holger
authors.initials: H
authors.lastname: Stepan
authors.forename: Annegret
authors.initials: A
authors.lastname: Geipel
authors.forename: Friederike
authors.initials: F
authors.lastname: Schwarz
authors.forename: Thomas
authors.initials: T
authors.lastname: Krämer
authors.forename: Niels
authors.initials: N
authors.lastname: Wessel
authors.forename: Renaldo
authors.initials: R
authors.lastname: Faber
mesh_terms: 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
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; C064206:ENG protein, human; D000071063:Endoglin; D011956:Receptors, Cell Surface