Prediction of preeclampsia by combining serum histidine-rich glycoprotein and uterine artery Doppler.
BACKGROUND
Preeclampsia is associated with both maternal and perinatal morbidity and mortality. Histidine-rich glycoprotein (HRG) is a protein interacting with angiogenesis, coagulation, and inflammatory responses, processes known to be altered in preeclamptic pregnancies. Significantly lower levels of HRG have been demonstrated as early as in the first trimester in women later developing preeclampsia compared with normal pregnancies. The aim of this study was to investigate whether the combination of HRG and uterine artery Doppler ultrasonography can be used as a predictor of preeclampsia.


METHODS
A total of 175 women were randomly selected from a case-control study; 86 women had an uncomplicated pregnancy and 89 women later developed preeclampsia. Blood samples and pulsatility index (PI) were obtained from both cases and controls in gestational week 14.


RESULTS
HRG levels were significantly lower in women who developed preterm preeclampsia compared with controls, but not for women developing preeclampsia in general. PI was significantly higher in the preeclampsia group compared with controls, especially in preterm preeclampsia. The combination of HRG and PI revealed a sensitivity of 91% and a specificity of 62% for preterm preeclampsia.


CONCLUSIONS
The combination of HRG and uterine artery Doppler may predict preterm preeclampsia in early pregnancy.
Department of Women's and Children's Health, Uppsala University, Sweden. marie.bolin@kbh.uu.se
Marie
M
Bolin
Anna-Karin
AK
Wikström
Eva
E
Wiberg-Itzel
Anna-Karin
AK
Olsson
Maria
M
Ringvall
Inger
I
Sundström-Poromaa
Ove
O
Axelsson
Basky
B
Thilaganathan
Helena
H
Åkerud
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015536:Down-Regulation; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005865:Gestational Age; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011506:Proteins / Q000032:analysis*; D011673:Pulsatile Flow; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D055988:Uterine Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000099053:Histidine-Rich Glycoprotein
D015415:Biomarkers; D011506:Proteins; D000099053:Histidine-Rich Glycoprotein