Uterine artery Doppler and biochemical markers (PAPP-A, PIGF, sFlt-1, P-selectin, NGAL) at 11 + 0 to 13 + 6 weeks in the prediction of late (> 34 weeks) pre-eclampsia.
OBJECTIVE
To determine the performance of screening for late pre-eclampsia (PE) by maternal characteristics, uterine artery Doppler and a set of biochemical markers at 11 + 0 to 13 + 6 weeks' gestation.


METHODS
Prospectively enrolled women at 11 + 0 to 13 + 6 weeks. Maternal characteristics, highest UtA pulsatility index and serum placental biomarkers including pregnancy-associated plasma protein-A, placental growth factor, soluble fms-like tyrosine kinase 1, P-selectin and neutrophil gelatinase-associated lipocalin were recorded.


RESULTS
The rate of PE was 2.5% (13/528). Four (0.8%) had severe PE. A combined screening model that included placental growth factor, soluble fms-like tyrosine kinase 1 and neutrophil gelatinase-associated lipocalin could detect 77% of PE at a 10% false-positive rate. Mean risk for mild PE was 8.8% ± 6.4, mean risk for severe PE was 38.6% ± 4.3. Mean risk for controls was 2% ± 4.1.


CONCLUSIONS
This combination of maternal biochemical variables in the first trimester can detect a consistent number of late PE. Further studies on a new and independent series of data could confirm the presented results.
Department of Obstetrics and Gynecology, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
Aly
A
Youssef
Francesca
F
Righetti
Danila
D
Morano
Nicola
N
Rizzo
Antonio
A
Farina
D000209:Acute-Phase Proteins; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005544:Forecasting; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood; D008403:Mass Screening; D008565:Membrane Proteins / Q000097:blood; D019007:P-Selectin / Q000097:blood; D011225:Pre-Eclampsia / Q000097:blood / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011263:Pregnancy Trimester, Third; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000097:blood; D018617:Ultrasonography, Doppler, Pulsed; D055988:Uterine Artery / Q000000981:diagnostic imaging; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood
D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008565:Membrane Proteins; D019007:P-Selectin; C098069:PIGF protein, human; D011518:Proto-Oncogene Proteins; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1; D011266:Pregnancy-Associated Plasma Protein-A