ANALYSIS OF THE EFFICACY OF THE MINI-COMBINED TEST FOR THE PREDICTION OF MODERATE LATE-ONSET PREECLAMPSIA
- Authors: Dubrovina S.O1, Mutsalkhanova Y.S1, Vasilyeva V.V1
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Affiliations:
- Rostov State Medical University
- Issue: No 6 (2018)
- Pages: 23-28
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/295344
- ID: 295344
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Abstract
Background. Despite a significant number of studies, the predictors of preeclampsia (PE), especially the more frequently occurring late-onset PE, remain understudied, which limits the ability to predict and treat this threatening complication of pregnancy. Objective. Analysis of the efficacy of the mini-combined test for the Prediction of moderate late-onset PE. Methods. Based on a retrospective analysis of the clinical data of 645 pregnant women, two groups were formed: pregnant women with moderate late-onset PE and patients without PE. Clinical and anamnestic parameters (age, body mass index, mean blood pressure) and biochemical marker -pregnancy-associated plasma protein A - were assessed. Results. Prognostic significance of clinical maternal factors determining the prognosis of PE - age, mean blood pressure, and body mass index - was confirmed. The predictive efficacy of the mini-combined test was 44%, with 10% false-positive results. Conclusion. The low prognostic significance of the mini-combined test for late-onset PE is shown. It is concluded that for a timely early prediction of moderate late-onset PE, a search for new markers is necessary.
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About the authors
S. O Dubrovina
Rostov State Medical University
Email: s.dubrovina@gmail.com
MD, Prof., Chief Researcher Rostov-on-Don, Russia
Yu. S Mutsalkhanova
Rostov State Medical UniversityRostov-on-Don, Russia
V. V Vasilyeva
Rostov State Medical UniversityRostov-on-Don, Russia
References
- Itoh H., Kanayama N. Obesity and risk of Preeclampsia. Med. J. Obstet. Gynecol. 2014;2(2):1024.
- Сидорова И.С. Никитина Н.А. Преклампсия или гестоз: возможен ли компромисс? Status Praesens. Акушерство, гинекология, бесплодный брак. 2013;2(13):17-24.
- Дубовой А.А. Тяжелая преэклампсия: особенности ангиогенного статуса. Дисс. канд. мед. наук. Ставрополь, 2016. 165 с.
- Ходжаева З.С., Акатьева А.С., Холин А.М., и др. Молекулярные детерминанты развития ранней и поздней преэклампсии. Акушерство и гинекология. 2014;6:14-9.
- O'Gorman N., Wright D., Syngelaki A., et al. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11-13 weeks of gestation. Am. J. Obstet. Gynecol. 2016;214(103):1-12.
- National Collaborating Centre for Women's and Children's Health (UK). Hypertension in Pregnancy: The Management of Hypertensive Disorders During Pregnancy. London: RCOG Press, 2010.
- Zhang J.Z., He J. Risk factors of recurrent preeclampsia and its relation to maternal and offspring outcome. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2015;44(3):258-63.
- ACOG. First-trimester risk assessment for early-onset preeclampsia. Obstet. Gynecol. 2015;126:25-7.
- O'Gorman N., Wright D., Poon L., et al. Multicenters creening for preeclampsia by maternal factors and biomarkers at 11-13 weeks' gestation: comparison to NICE guidelines and ACOG recommendations. Ultrasound. Obstet. Gynecol. 2017;49:756-60.
- Diab A.E., El-Behery M.M., Ebrahiem M.A., Shehata A.E. Angiogenic factors for the prediction of preeclampsia in women with abnormal midtrimester uterine artery Doppler velocimetry. Int. J. Gynaecol. Obstet. 2008;102(2):146-51.
- Crispi F., Llurba E., Dominguez C., et al. Predictive value of angiogenic factors and uterine artery Doppler for early - versus late-onset preeclampsia and intrauterine growth restriction. Ultrasound. Obstet. Gynecol. 2008;31(3):303-9.
- Wright D., Syngelaki A., Akolekar R., Poon L.C., Nicolaides K.H. Competing risks model in screening for preeclampsia by maternal characteristics and medical history Am. J. Obstet. Gynecol. 2015;213(1):1-10.
- Verlohren S., Herraiz I., Lapaire O., et al. The sFlt-1/PlGF ratio in different types of hypertensive pregnancy disorders and its prognostic potential in preeclamptic patients. Am. J. Obstet. Gynecol. 2012;206(1);e1-8.
- Bredaki F.E., Mataliotakis M., Wright A., et al. Maternal serum alpha-fetoprotein at 12, 22 and 32 weeks' gestation in screening for preeclampsia. Ultrasound. Obstet. Gynecol. 2016; 47:466-71.
- Tan M., Koutoulas L., Wright D., et al. A study protocol for the prospective validation study: Screening programme for pre-eclampsia (SPREE). Accepted Article. Study Registration Number: ISRCTN83611527.
- Valensise H., Vasapollo B., Gagliardi G., Novelli G.P. Early and late preeclampsia: two different maternal hemodynamic states in the latent phase of the disease. Hypertension. 2008;52:873-80.
- Athukorala C., Rumbold A.R., Willson K.J., Crowther C.A. The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy Childbirth. 2010 Sep 17;10:56. doi: 10.1186/1471-2393-10-56.
- Vinturache A., Moledina N., McDonald S., et al. Pre-pregnancy Body Mass Index (BMI) and delivery outcomes in a Canadian population. BMC Pregnancy Childbirth. 2014;14(1):422.
- Cetin I., Huppertz B., Burton G., et al. Pregenesys pre-eclampsia markers consensus meeting: What do we require from markers, risk assessment and model systems to tailor preventive strategies? Placenta. 2011;32(suppl. 1):4-16.
- Harris L.K., Keogh R.J., Wareing M., et al. Association of inflammatory cytokines, lipid peroxidation end products and nitric oxide with the clinical severity and fetal outcome in preeclampsia in Indian women. Indian J. Clin. Biochem. 2014;29(2): 139-44.
- Cnossen J.S., Vollebregt K.C., de Vrieze N., et al. Accuracy of mean arterial pressure and blood pressure measurements in predicting preeclampsia: Systematic review and meta-analysis. BMJ. 2008;336:1117-20.
- Akolekar R., Syngelaki A., Sarquis R., et al. Prediction of early, intermediate and late preeclampsia from maternal factors, biophysical and biochemical markers at 11-13 weeks. Prenat. Diagn. 2011;31:66-74.
- Redman C.W., Staff A.C. Preeclampsia, biomarkers, syncytiotrophoblast stress, and placental capacity. Am. J. Obstet. Gynecol. 2015;213(9):1-11.
- Gallo D.M., Wright D., Akolekar R., et al. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 19-24 weeks' gestation. Am. J. Obstet. Gynecol. 2016 May;214(5):619.e1-619.e17. Doi:10.1016/j. ajog.2015.11.016. Epub 2015 Nov 25.
- Poon L.C., Akolekar R., Lachmann R., et al. Hypertensive disorders in pregnancy: Screening by biophysical and biochemical markers at 11-13 weeks. Ultrasound Obstet. Gynecol. 2010; 35:662-70.
- Bilagi A., Burke D.L. Association of maternal serum PAPP-A levels, nuchal translucency and crown-rump length in first trimester with adverse pregnancy outcomes: retrospective cohort study. Prenat. Diagn. 2017;37(7):705-11.
- Giguere Y., Masse' J., Riault S., et al. Screening for preeclampsia early in pregnancy: performance of a multivariable model combining clinical characteristics and biochemical markers. BJOG. 2015;122:402-10.
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