A prospective study on first trimester prediction of ischemic placental diseases.
OBJECTIVE
The objective of the study is to assess the predictive power of mean uterine artery pulsatility index (UtA PI), maternal serum placental growth factor (PlGF) and placenta associated plasma protein A levels for the development of ischemic placental diseases (IPD) in a cohort of unselected singleton pregnancies during the first trimester combined test period.


METHODS
A sample of 880 pregnancies was registered between September 2014 and January 2016. After routine examination for first trimester combined test, UtA PI was measured, and maternal serum was obtained and stored at -80 °C for PlGF assessment.


RESULTS
Early-onset preeclampsia, late-onset preeclampsia and placental dysfunction-related fetal growth restriction were observed in 6 (0.7%), 17 (2.0%) and 27 (3.2%) cases, respectively. IPD requiring delivery before 34 weeks of gestation could be predicted with a sensitivity, specificity, positive predictive value and negative predictive value of 76.2%, 90.2%, 20.2% and 99.1%, respectively.


CONCLUSIONS
A combination of UtA PI, placenta associated plasma protein A and PlGF was proven to be successful in the first trimester prediction of IPD, with the highest sensitivity in the subgroup who required delivery before 34 weeks of gestation. In reducing the number of pregnancies that should be followed-up, further studies for new biomarkers are needed. © 2017 John Wiley & Sons, Ltd.
Department of Obstetrics and Gynecology, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
Gulnar
G
Nuriyeva
Division of Perinatology, Department of Obstetrics and Gynecology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Semir
http://orcid.org/0000-0001-7621-7503
S
Kose
Department of Molecular Medicine, Dokuz Eylul University Institute of Health Sciences, Balcova, Izmir, Turkey.
Gamze
G
Tuna
Department of Medical Biochemistry, Dokuz Eylul University Institute of Health Sciences, Balcova, Izmir, Turkey.
Melis
M
Kant
Department of Medical Biochemistry, Dokuz Eylul University Institute of Health Sciences, Balcova, Izmir, Turkey.
Merve
M
Akis
Division of Perinatology, Department of Obstetrics and Gynecology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Sabahattin
S
Altunyurt
Department of Medical Biochemistry, Dokuz Eylul University Institute of Health Sciences, Balcova, Izmir, Turkey.
Gül Huray
GH
Islekel
Department of Obstetrics and Gynecology, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
Omer Erbil
OE
Dogan
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007511:Ischemia / Q000175:diagnosis*; D010922:Placenta Diseases / Q000175:diagnosis* / Q000503:physiopathology; D021041:Placental Circulation / Q000502:physiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011379:Prognosis; D016216:Ultrasonography, Prenatal / Q000379:methods