Serum placental growth factor levels and uterine artery pulsatility index at 11-13+6 weeks gestation as early predictors of pre-eclampsia: prospective observational study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240135Keywords:
Eclampsia, Placental growth factor levels, Pre-eclampsia, Uterine artery doppler pulsatility indexAbstract
Background: To detect serum placental growth factor levels and uterine artery doppler pulsatility index for predicting pre-eclampsia and assess their association with the severity of pre-eclampsia.
Methods: A prospective observational study involving 160 antenatal women, from 11-13+6 weeks gestation attending antenatal clinic at tertiary care center during study period of 18 months. Serum placental growth factor levels and uterine artery doppler mean pulsatility index measured and patients were followed upto delivery and observed for the development of pre-eclampsia and its severity.
Results: Placental growth factor value cut-off was 40.33pg/ml with the sensitivity of 97.5 % and specificity was 98.3%. For the pulsatility index value of 1.85, the sensitivity was found to be 74.4% and specificity was found to be 92.5%. Mean serum placental growth factor levels for pre-eclampsia patients was 25.09pg/ml and for normotensive patients mean level was 65.05pg/ml. Mean uterine artery doppler pulsatlity index for pre-eclampsia patients was 2.02 and for normotensive patients was 1.39. Mean PI value increased with increasing severity of preeclampsia.
Conclusions: Early recognition of women will help initiation of prophylactic measures and enhanced surveillance. First trimester uterine artery doppler with serum placental growth factor together with maternal characteristics can be used as a reliable screening test for preeclampsia prediction and to reduce feto-maternal morbidity.
References
Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams Obstetrics. 23rd ed. Mc Graw Hill. 2009;23(34):706-707.
Roberts JM, Creasy RK, Resnik. Pregnancy related Hypertension. Maternal Foetal Medi. 1998;4:883-72.
Chau K, Hennessy A, Makris A. Placental growth factor and pre-eclampsia. J Human Hyperten. 2017;31(12):782-6.
Kasdaglis T, Aberdeen G, Turan O, Kopelman J, Atlas R, Jenkins C, et al. Placental growth factor in the first trimester: relationship with maternal factors and placental Doppler studies. J Int Soci Ultra Obstet Gynecol. 2010;35(3):280-5.
Lopez-Mendez MA, Martinez-Gaytan V, Cortes-Flores R, Ramos-Gonzalez RM, Ochoa-Torres MA, Garza-Veloz I, et al. Doppler ultrasound evaluation in preeclampsia. BMC Res Notes. 2013;6(1):1-6.
Andrew C, Vasanthalakshmi GN, Sujatha K. Prediction of pre- eclampsia by maternal uterine artery doppler at 11-14 weeks of gestation. Ind J Obstet Gynaecol Res. 2015;2(4):246-9.
Sciscione AC, Hayes EJ. Uterine artery Doppler flow studies in obstetric practice. Ame J Obstet Gynecol. 2009;201(2):121-6.
Antsaklis A, Daskalakis G. Uterine artery Doppler in the prediction of preeclampsia and adverse pregnancy outcome. Donald school J Ultra Obstet Gynecol. 2010;4(2):117-22.
Gullai N, Stenczer B, Molvarec A, Fugedi G, Veresh Z, Nagy B, et al. Evaluation of a rapid and simple placental growth factor test in hypertensive disorders of pregnancy. Hypertens Res. 2013;36(5):457-462.
Jeltsje S Cnossen, Rachel K Morris, Gerben te R, Ben W J, Joris A M, Arri C, et al. Use of uterine artery doppler ultrasonography to predict preeclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ. 2008;11:178(6):701-11.
Dover N, Gulerman HC, Celen S, Kahyaoglu S, Yenicesu O. Placental growth factor: as an early second trimester predictive marker for preeclampsia in normal and high-risk pregnancies in a turkish population. J Obstet Gynecol Ind. 2013;63(3):158-63.
Nahid S, Khadije YM. The study of diagnostic value of placental growth factor for predicting pre-eclampsia in the first trimester of pregnancy. Glob J Surg. 2014;2(1):12-5.
McCarthy FP, Gill C, Seed PT, Bramham K, Chappell LC, Shennan AH. Comparison of three commercially available placental growth factor‐based tests in women with suspected preterm pre‐eclampsia: the COMPARE study. Ultra Obstet Gynecol. 2019;53(1):62-7.