title: Pulsatility index in combination with biomarkers or mean arterial pressure for the prediction of pre-eclampsia: Systematic literature review and meta-analysis.
abstract: BACKGROUND
  Our objective was to perform a meta-analysis examining the sensitivity of pulsatility index (PI) and various biomarkers and PI and mean arterial pressure (MAP) for the prediction of pre-eclampsia.
  
  
  METHODS
  PubMed, CENTRAL, and Embase databases were searched from inception until 8 May 2014 using combinations of the search terms: pre-eclampsia, ultrasonography, pregnancy, biomarker, mean arterial pressure, placental protein 13, pregnancy-associated plasma protein-A, placental growth factor, activin A, inhibin A, pulsatility index. The pooled sensitivity of PI + biomarkers and PI + MAP were calculated, and reported with corresponding 95% confidence intervals (CIs).
  
  
  RESULTS
  Fifteen studies were included in the meta-analysis. The pooled sensitivity of all biomarkers for the prediction of pre-eclampsia was 0.669 (95% CI 0.610-0.723), for the prediction of early-onset pre-eclampsia was 0.830 (95% CI 0.794-0.861), and for the prediction of late-onset pre-eclampsia was 0.564 (95% CI 0.499-0.627). Similarly, the predictive ability of PI + MAP for early-onset pre-eclampsia was good (sensitivity 0.894), while that for late-onset was poor (sensitivity 0.570).
  
  
  CONCLUSIONS
  The combination of PI and different biomarkers or MAP exhibits a good predictive ability for early-onset pre-eclampsia, and poor predictive ability for late-onset pre-eclampsia.
authors.affiliation: a Department of Obstetrics and Gynecology , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai 200233 , P.R. China.
authors.forename: Xiao-Lu
authors.initials: XL
authors.lastname: Zhu
authors.forename: Juan
authors.initials: J
authors.lastname: Wang
authors.forename: Rong-Zhen
authors.initials: RZ
authors.lastname: Jiang
authors.forename: Yin-Cheng
authors.initials: YC
authors.lastname: Teng
mesh_terms: D028341:Activins / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D005260:Female; D037161:Galectins / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis*; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D011673:Pulsatile Flow; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D037161:Galectins; C038195:LGALS13 protein, human; C000608036:PGF protein, human; D011257:Pregnancy Proteins; C422405:activin A; C422362:inhibin A; D028341:Activins; D000072483:Placenta Growth Factor; D007265:Inhibins; D011266:Pregnancy-Associated Plasma Protein-A
keywords: Biomarker; mean arterial pressure; meta-analysis; placental growth factor; placental protein 13; pre-eclampsia; pregnancy-associated plasma protein-A; pulsatility index