title: First trimester uterine artery Doppler, sFlt-1 and PlGF to predict preeclampsia in a high-risk population.
abstract: OBJECTIVE
  The study aims to evaluate the accuracy of combining uterine artery Doppler (UAD), PlGF and sFlt-1 in the first trimester for preeclampsia screening.
  
  
  METHODS
  Prospectively enrolled women at high risk of preeclampsia were included. Transabdominal UAD measurements and serum biomarkers were collected between 11 and 13 weeks of gestation in three university hospitals and in one general hospital. The main outcome was preeclampsia. UAD parameters and biomarker levels among women with preeclampsia were compared with those of women in the unaffected group in univariate and multivariate analyses.
  
  
  RESULTS
  Out of 226 women included from May 2007 to January 2011, 27 (11.9%) women developed preeclampsia. Among women affected by preeclampsia, the lowest pulsatility index was higher (p = 0.02), bilateral notching was more frequent (p = 0.01), and PlGF was lower (p < 0.001). No significant differences were observed for other indicators. The multivariate model, adjusted for laboratory and sonographic indicators, had an area under the curve (AUC) estimated at 0.76, which was not significantly different from the AUC of the univariate model adjusted only for PlGF (p = 0.7).
  
  
  CONCLUSIONS
  In a high-risk population, PlGF in the first trimester is useful for predicting preeclampsia, but neither sFlt-1 nor any UAD indices improved the prediction of preeclampsia.
authors.affiliation: a Department of Obstetrics, Gynecology and Fetal Medicine, University Hospital of Tours , 2 Boulevard Tonnellé, Tours Cedex 9 , France.|b Department of Medicine, University François Rabelais , Tours , France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Diguisto
authors.affiliation: b Department of Medicine, University François Rabelais , Tours , France.|c Department of Biochemistry, University Hospital Tours , Tours , France.
authors.forename: Eric
authors.initials: E
authors.lastname: Piver
authors.affiliation: d INSERM CIC 1415, University Hospital Tours , Tours , France.
authors.forename: Amélie Le
authors.initials: AL
authors.lastname: Gouge
authors.affiliation: a Department of Obstetrics, Gynecology and Fetal Medicine, University Hospital of Tours , 2 Boulevard Tonnellé, Tours Cedex 9 , France.|e Maternité Notre Dame de Bon Secours, Groupe Hospitalier Saint Joseph , Paris , France.
authors.forename: Florence
authors.initials: F
authors.lastname: Eboue
authors.affiliation: f Department of Obstetrics, University Hospital of Nantes , Nantes , France.
authors.forename: Claudine Le
authors.initials: CL
authors.lastname: Vaillant
authors.affiliation: g Department of Obstetrics, University Hospital of Poitiers , Poitiers , France.
authors.forename: Martine
authors.initials: M
authors.lastname: Maréchaud
authors.affiliation: g Department of Obstetrics, University Hospital of Poitiers , Poitiers , France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Goua
authors.affiliation: b Department of Medicine, University François Rabelais , Tours , France.|d INSERM CIC 1415, University Hospital Tours , Tours , France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Giraudeau
authors.affiliation: a Department of Obstetrics, Gynecology and Fetal Medicine, University Hospital of Tours , 2 Boulevard Tonnellé, Tours Cedex 9 , France.|b Department of Medicine, University François Rabelais , Tours , France.
authors.forename: Franck
authors.initials: F
authors.lastname: Perrotin
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D062145:Maternal Serum Screening Tests; D000072483:Placenta Growth Factor / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood* / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011446:Prospective Studies; D012372:ROC Curve; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; C000608036:PGF protein, human; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: Angiogenic markers; predict; pulsatility index; screening; severe preeclampsia