SCREENING OF EARLY PREECLAMPSIA IN THE FIRST TRIMESTER OF PREGNANCY ON THE BASIS OF COMBINED ESTIMATE OF MATERNAL SERUM PLACENTAL GROWTH FACTOR AND UTERINE ARTERY DOPPLER


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Abstract

Objective. To study the prognostic value of determining the concentration of maternal placental growth factor (PlGF) in combination with uterine artery Doppler data during screening for prediction of early preeclampsia in the first trimester of pregnancy. Subjects and methods. The prospective nested case-control study investigated single pregnancies at 11 weeks + 0 day to 13 weeks + 6 days in 13 women who required delivery before 34 weeks of gestation and in 632 women with uncomplicated pregnancy. The results were expressed as relative multiples of the median (MoM). A logistic regression model was used to calculate sensitivity and false-positive rates. Results. In cases of preeclampsia requiring delivery before 34 weeks’ gestation as compared to the control group, the median uterine artery pulsatility index (PI) was higher (1.31 MoM) while the median serum PlGF levels was lower (0.37 MoM; p < 0.001). Simulation showed that the false-positive rate of PlGF screening at a 90% detection rate for early preeclampsia, with uterine artery pulsatility index, and their combination was 12, 67, and 9%, respectively. Conclusion. Effective screening for early preeclampsia (delivery before 34 weeks) may be made in the combined estimation of maternal serum PlGF levels and uterine artery Doppler findings in the first trimester of pregnancy.

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About the authors

Alexey Mikhaylovich Kholin

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_kholin@oparina4.ru
M.D., Research Associate, Department of Maternal Fetal Medicine Moscow 117997, Ac. Oparina str. 4, Russia

Zulfiya Sagdullaevna Khodzhaeva

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: z_khodzhaeva@oparina4.ru
M.D., Ph.D., Professor, Principal Investigator, Department of Maternal-Fetal Medicine Moscow 117997, Ac. Oparina str. 4, Russia

Tatyana Yur'evna Ivanets

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: t_ivanets@oparina4.ru
M.D., Head of Scientific and Diagnostic Laboratory Moscow 117997, Ac. Oparina str. 4, Russia

Alexander Iosifovich Gus

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_gus@oparina4.ru
M.D., Ph.D., Head of Ultrasound Department Moscow 117997, Ac. Oparina str. 4, Russia

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