title: Could first-trimester assessment of placental functions predict preeclampsia and intrauterine growth restriction? A prospective cohort study.
abstract: OBJECTIVE
  To examine the role of first-trimester uterine artery Doppler, serum β-hCG and pregnancy-associated placental protein-A (PAPP-A) in prediction of preeclampsia and IUGR.
  
  
  METHODS
  A total of 100 pregnant women in the 11-14 weeks' gestation were examined using uterine artery Doppler, serum β-hCG and PAPP-A. All women were followed-up for development of preeclampsia or IUGR.
  
  
  RESULTS
  A total of 94 women completed the study of which 7 (7.4%) developed complications. Uterine artery PI and RI were significantly higher whereas serum β-hCG and PAPP-A levels were significantly reduced in patients who developed complications when compared with those who did not. Uterine artery PI had the highest sensitivity (100%) but a low specificity (56% and 45%) in prediction of preeclampsia and IUGR, respectively. Adding PAPP-A to uterine artery PI elevated the specificity into 94.44% and 95.51%, respectively. Combined PI and β-hCG elevated the specificity into 88.89% and 89.89%, respectively.
  
  
  CONCLUSIONS
  Our study suggests that first-trimester uterine artery impedance, as measured by Doppler ultrasound as well as low serum biomarkers (β-hCG and PAPP-A) can be used for prediction of preeclampsia and IUGR. The most sensitive is uterine artery PI. Adding β-hCG to PI improves specificity in prediction of both preeclampsia and IUGR. Uterine artery PI plus PAPP-A is the best combination for prediction of both preeclampsia and IUGR.
authors.affiliation: a Obstetrics and Gynecology Department and.
authors.forename: Ghada Abdel Fattah
authors.initials: GA
authors.lastname: Abdel Moety
authors.affiliation: a Obstetrics and Gynecology Department and.
authors.forename: Maged
authors.initials: M
authors.lastname: Almohamady
authors.affiliation: a Obstetrics and Gynecology Department and.
authors.forename: Nadine Alaa
authors.initials: NA
authors.lastname: Sherif
authors.affiliation: a Obstetrics and Gynecology Department and.
authors.forename: Ayman N
authors.initials: AN
authors.lastname: Raslana
authors.affiliation: a Obstetrics and Gynecology Department and.
authors.forename: Tarek Fawzy
authors.initials: TF
authors.lastname: Mohamed
authors.affiliation: a Obstetrics and Gynecology Department and.
authors.forename: Hazem Mohamed Abd
authors.initials: HM
authors.lastname: El Moneam
authors.affiliation: b Clinical Pathology Department, Faculty of Medicine , Kasr Al Aini Teaching hospital, Cairo University , Cairo , Egypt , and.
authors.forename: Abeer Mohamed
authors.initials: AM
authors.lastname: Mohy
authors.affiliation: c Kasr Al Aini Teaching Hospital , Cairo University , Cairo , Egypt.
authors.forename: Mohamed A F M
authors.initials: MA
authors.lastname: Youssef
mesh_terms: D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood* / Q000000981:diagnostic imaging; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011446:Prospective Studies; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D055815:Young Adult
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A
keywords: IUGR; PAPP-A; preeclampsia; serum B-hCG; uterine artery Doppler