title: Serum tumor necrosis factor-α level and uterine artery Doppler indices at 11-13 weeks' gestation for preeclampsia screening in low-risk pregnancies: a prospective observational study.
abstract: Preeclampsia affects 1-2% of human pregnancies with no effective screening test. Studies have found some association between cytokines/other biomarkers and the later onset of preeclampsia. The challenge has been to find indicators with sufficient positive predictive value. A prospective observational study recruiting 500 low-risk pregnant women was carried out. Serum TNF-α and uterine artery Doppler were measured at 11-13 weeks. TNF-α cut-off value ≥ 1 4 pg/mL had a sensitivity of 67.8% and a specificity of 98% in predicting PE with PPV of 79.4% and NPV of 96.4%. Mean uterine artery PI ≥ 1.7 had a 100% sensitivity and 84.4% specificity in predicting PE, with a PPV of 41.7% and NPV of 100%. When combining both parameters together we had 88.6% sensitivity and 100% specificity in predicting PE with a PPV of 100% and NPV of 98.6%. Serum TNF-α assay improves the performance of mean uterine artery PI at 11-13 weeks for PE screening and the combination of both tests can rule out PE in the case of normal results.
authors.affiliation: Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt. Electronic address: mostafafouadg@gmail.com.
authors.forename: Mostafa Fouad
authors.initials: MF
authors.lastname: Gomaa
authors.affiliation: Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.
authors.forename: Ahmed Hamdy
authors.initials: AH
authors.lastname: Naguib
authors.affiliation: Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.
authors.forename: Khaled Hassan
authors.initials: KH
authors.lastname: Swedan
authors.affiliation: Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Cairo, Egypt.
authors.forename: Samia Salah
authors.initials: SS
authors.lastname: Abdellatif
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D018618:Echocardiography, Doppler, Color; D005865:Gestational Age; D011225:Pre-Eclampsia / Q000097:blood / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055988:Uterine Artery / Q000000981:diagnostic imaging
chemical_list: D014409:Tumor Necrosis Factor-alpha
keywords: Preeclampsia; TNF; Uterine artery Doppler