title: Combination of uterine artery Doppler velocimetry and maternal serum placental growth factor estimation in predicting occurrence of pre-eclampsia in early second trimester pregnancy: a prospective cohort study.
abstract: OBJECTIVE
  To determine the effectiveness of the combined use of uterine artery Doppler velocimetry (UADV) and estimation of maternal serum placental growth factor (PlGF) levels in early second trimester (20-22 weeks of gestation) in identifying pregnant women at risk of developing pre-eclampsia.
  
  
  METHODS
  Prospective cohort study on 1104 pregnant women with singleton pregnancies between May 2009 and December 2010. UADV and maternal serum PlGF estimation were done at 20-22 weeks' gestation. Association between the two variables and the occurrence of pre-eclampsia was analyzed by logistic regression analysis and odds ratio was computed. The results were considered significant when p was <0.05.
  
  
  RESULTS
  Logistic regression analysis showed that both abnormal UADV (odds ratio (OR) 4.1; 95% CI 2.3-7.2; p=0.000) and serum PlGF<188pg/ml (OR 3.6; 95% CI 1.95-6.5; p=0.000) are independent variables in the occurrence of pre-eclampsia, and the difference between the association of these two variables with pre-eclampsia was statistically insignificant as 95% CI values overlap. Multivariate logistic regression analysis showed that a combination of abnormal UADV and serum PlGF<188pg/ml at 20-22 weeks had a very poor association (OR 1.1; 95% CI 0.3-3.8; p=0.938) with the occurrence of pre-eclampsia, as the 95% CI values encompass 1 and p is >0.05.
  
  
  CONCLUSIONS
  UADV and maternal serum PlGF estimation at 20-22 weeks of gestation are strong predictors of the occurrence of pre-eclampsia when used individually but in combination their association with pre-eclampsia is not significant.
authors.affiliation: Department of Anatomy, Lady Hardinge Medical College & Smt. Sucheta Kriplani Hospital, Shaheed Bhagat Singh Marg, New Delhi, India. drsanjib79@gmail.com
authors.forename: Sanjib Kumar
authors.initials: SK
authors.lastname: Ghosh
authors.forename: Shashi
authors.initials: S
authors.lastname: Raheja
authors.forename: Anita
authors.initials: A
authors.lastname: Tuli
authors.forename: Chitra
authors.initials: C
authors.lastname: Raghunandan
authors.forename: Sneh
authors.initials: S
authors.lastname: Agarwal
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D016015:Logistic Models; D015999:Multivariate Analysis; D015588:Observer Variation; D016017:Odds Ratio; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D055988:Uterine Artery; D055815:Young Adult
chemical_list: C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor