title: PP055. Preliminary results of the more prepared study (microparticle orientated risk evaluation in the prediction of preeclampsia among risk gravidas): A multicenter prospective prognostic marker study.
abstract: BACKGROUND
  Preeclampsia (PE) is a potentially dangerous pregnancy pathology contributing to a higher worldwide mortality and morbidity. The negative influence of syncytiotrophoblastic microparticles (STBMs) on the placenta and maternal endothelia is thought to play a key role in generating the inflammatory effects that lead to PE symptoms. Doppler sonography of the uterine arteries assists in identifying a risk population, however, the positive predictive value for this method is low.
  
  
  OBJECTIVE
  Aim of this study is to evaluate whether STBMs can serve as an accessory marker to conventional Doppler sonography to better identify pregnant women who will actually develop PE.
  
  
  METHODS
  Pregnant women between 19-21 gestational weeks (GW) with abnormal uterine perfusion were enrolled into this prospective study. Plasma samples were taken at inclusion (baseline) and at two further visits at 8 week intervals to follow STBM concentration alterations during pregnancy. The primary endpoint assessed is PE and/or hemolysis, elevated liver, low platelets (HELLP) syndrome. Other PE-associated pathologies (intrauterine growth retardation [IUGR], intrauterine fetal demise [IUFD], placental abruption, premature delivery) constitute the secondary endpoints. Maternal STBM concentrations were measured using a home made Enzyme Linked Sorbent Assay (ELSA) which specifically measures STBMs. The receiver operating characteristics (ROC) for baseline measures are graphically displayed and area under curve (AUC) is estimated including 95% confidence levels.
  
  
  RESULTS
  Of the 73 women included in the study, 16 developed PE (cases) and 56 did not (control). After analyses of mid-gestational probes, the ROC curve was in close proximity to the line of no-discrimination.
  
  
  CONCLUSIONS
  Our preliminary results indicate that the maternal STBM concentration at mid-gestation does not predict the development of PE or associated pregnancy pathologies. Further analysis is underway to assess whether STBM measurements at later gestational time points can predict PE shortly before onset of disease.
authors.affiliation: Placenta-Lab/Obstetrics Department, Jena, Germany.
authors.forename: J S
authors.initials: JS
authors.lastname: Fitzgerald
authors.affiliation: Placenta-Lab/Obstetrics Department, Jena, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Göhner
authors.affiliation: Placenta-Lab/Obstetrics Department, Jena, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Markert
authors.affiliation: Obstetrics Department, Jena, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Groten
authors.affiliation: Center for Sepsis Control and Care, University Hospital Jena, Jena, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Sossdorf
authors.affiliation: Center for Sepsis Control and Care, University Hospital Jena, Jena, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Lösche
authors.affiliation: Obstetrics Department, Jena, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Schleußner