title: How accurate are placental growth factor, urate, lactate dehydrogenase and proteinuria in diagnosing preeclampsia and its severity?
abstract: OBJECTIVE
  The objective was to assess the diagnostic accuracy of serum and urinary placental growth factor (sPlGF and uPlGF, respectively), urate, lactate dehydrogenase (LDH), and proteinuria for diagnosing and differentiating between women with preeclampsia and women with a normal healthy pregnancy, gestational hypertension, and gestational proteinuria.
  
  
  METHODS
  Urine and blood samples were taken from pregnant women diagnosed with late-onset severe preeclampsia (30 patients), mild preeclampsia (30 patients), gestational hypertension without meeting the criteria for preeclampsia (30 patients), gestational proteinuria without meeting the criteria for preeclampsia (30 patients), and healthy pregnant control women (30 patients). A receiver operating characteristic (ROC) curves analysis was performed to evaluate the diagnostic accuracy and to select the optimal cutoff points for different markers.
  
  
  RESULTS
  sPlGF is the best test for differentiating women with severe preeclampsia from women in all of the other groups (p=0.001). However, there was no significant difference between sPlGF and proteinuria in the 24-h urine collection (p=0.329) in this differentiation. uPlGF can be used to differentiate women with severe preeclampsia from women in all of the other groups. However, proteinuria in the 24-h urine collection is better than uPlGF for this differentiation (p=0.013).
  
  
  CONCLUSIONS
  sPlGF and uPlGF can be used to diagnose women with severe preeclampsia and should be considered at least as important as proteinuria in the diagnosis of preeclampsia. A large study that considers the cost-effectiveness of adding these markers to the diagnosis of preeclampsia should be conducted before our recommendation is applied.
authors.affiliation: Department of Obstetrics and Gynecology, Security Forces Hospital, Riyadh, Saudi Arabia; Faculty of Medicine, Menoufiya University, Egypt. Electronic address: khalil1464@hotmail.com.
authors.forename: Mohamed Ibrahim
authors.initials: MI
authors.lastname: Khalil
authors.affiliation: Department of Obstetrics and Gynecology, Security Forces Hospital, Riyadh, Saudi Arabia. Electronic address: esagr@sfh.med.sa.
authors.forename: Emad R
authors.initials: ER
authors.lastname: Sagr
authors.affiliation: Department of Obstetrics and Gynecology, Security Forces Hospital, Riyadh, Saudi Arabia. Electronic address: ralbahyan@sfh.med.sa.
authors.forename: Rawda
authors.initials: R
authors.lastname: Bahyan
authors.affiliation: Department of Obstetrics and Gynecology, Security Forces Hospital, Riyadh, Saudi Arabia. Electronic address: relrifaei@sfh.med.sa.
authors.forename: Rabab M
authors.initials: RM
authors.lastname: Elrifaei
authors.affiliation: Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia. Electronic address: mzahrani@sfh.med.sa.
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Alzahrani
authors.affiliation: Division of Clinical Chemistry, Department of Pathology and Lab Medicine, King Fahad National Guard Hospital, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: tamimiw@ngha.med.sa.
authors.forename: Waleed
authors.initials: W
authors.lastname: Tamimi
keywords: Lactate dehydrogenase; Placental growth factor; Preeclampsia; Proteinuria; Urate