First-trimester uterine artery Doppler and serum pregnancy-associated plasma protein-a in preeclampsia and chromosomal defects.
OBJECTIVE
We examined the potential value of the uterine artery pulsatility index (PI) in pregnancies with fetal aneuploidies and in those that developed preeclampsia (PE) with the aim of distinguishing between these complications in pregnancies with low pregnancy-associated plasma protein-A (PAPP-A).


METHODS
Uterine artery PI and serum PAPP-A at 11-13 weeks were measured in 165 cases of PE, including 33 that required delivery before 34 weeks (early PE) and 132 with late PE, and in 301 cases with aneuploidies, including 200 with trisomy 21. Each case of aneuploidy and PE was matched with 4 unaffected controls.


RESULTS
Serum PAPP-A was lower in early PE (0.58 multiples of the normal median, MoM) and in trisomy 21 (0.54 MoM), trisomy 18 (0.22 MoM) and Turner syndrome (0.51 MoM) - but not in late PE (0.90 MoM) - than in controls (1.01 MoM). Uterine artery PI was higher in early PE (1.52 MoM), late PE (1.20 MoM), trisomy 18 (1.20 MoM) and Turner syndrome (1.29 MoM) - but not in trisomy 21 (1.02 MoM) - than in controls (1.0 MoM).


CONCLUSIONS
The uterine artery PI at 11-13 weeks may be useful in distinguishing between low PAPP-A due to trisomy 21 and early PE.
Harris Birthright Research Centre for Foetal Medicine, King's College Hospital, London SE5 9RS, UK.
Ismini
I
Staboulidou
Alberto
A
Galindo
Nerea
N
Maiz
George
G
Karagiannis
Kypros H
KH
Nicolaides
D001158:Arteries / Q000000981:diagnostic imaging; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D025063:Chromosome Disorders / Q000097:blood* / Q000000981:diagnostic imaging / Q000378:metabolism; D018568:Crown-Rump Length; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008423:Maternal Age; D011225:Pre-Eclampsia / Q000097:blood* / Q000000981:diagnostic imaging / Q000378:metabolism; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging
D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A