Angiogenic factors for the prediction of pre-eclampsia in women with abnormal midtrimester uterine artery Doppler velocimetry.
OBJECTIVE
To determine whether assessing uterine perfusion and angiogenic factors concurrently in the second trimester improves the prediction of pre-eclampsia and intrauterine growth restriction (IUGR).


METHODS
Plasma levels of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) were measured for 108 women with abnormal uterine perfusion on Doppler velocimetry in the 23rd week. Later, 33 cases of pre-eclampsia and 9 of IUGR developed.


RESULTS
Compared with the plasma levels of the women whose pregnancies remained normal, sFlt-1 levels were significantly higher and PlGF levels significantly lower in the women whose pregnancies became complicated by pre-eclampsia and/or IUGR (P<0.001). The alterations were more pronounced in cases of early-onset pre-eclampsia and in cases of IUGR that necessitated delivery before 34 weeks. Using the sFlt-1/PlGF ratio, these complications could be predicted with 98% sensitivity, 95% specificity, and 93% positive predictive value.


CONCLUSIONS
Measuring uterine perfusion and angiogenic factors concurrently in the second trimester improved the prediction of pre-eclampsia and IUGR.
Diab
Abdalla E
AE
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt. abdalladiab@hotmail.com
El-Behery
Manal M
MM
Ebrahiem
Moustafa A
MA
Shehata
Amal E
AE
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D006801:Humans; D017078:Laser-Doppler Flowmetry; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000503:physiopathology; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D011262:Pregnancy Trimester, Second / Q000502:physiology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; D040281:Vascular Endothelial Growth Factor Receptor-1