First trimester uterine artery Doppler, sFlt-1 and PlGF to predict preeclampsia in a high-risk population

Diguisto, Caroline; Piver, Éric; Gouge, Amélie Le; Eboue, F.; Vaillant, C. Le; Maréchaud, M; Goua, Valérie; Giraudeau, Bruno; Perrotin, F.

doi:10.1080/14767058.2016.1183631

Cited by 18 publications

(16 citation statements)

References 24 publications

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“…In a prospective observational study of a high-risk population of women ( n = 226), sFlt-1 did not improve prediction of PE in multivariate models combining sFlt-1, PlGF and uterine artery Doppler measurements. 21 By contrast, a recent prospective nested case–control study of low-risk participants ( n = 740) demonstrated significantly higher concentrations of first trimester sFlt-1 in women who developed PE ( n = 44). 22 However, first trimester sFlt-1 was not reported as a significant predictor variable for PE in logistic regression models.…”

Section: Discussionmentioning

confidence: 86%

The role of biomarkers in predicting pre-eclampsia in high-risk women

et al. 2019

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Background There are limited data on performance of biomarkers to predict pre-eclampsia (PE) in high-risk women. This study investigated the ability of FABP4, PAPP-A, PlGF, sFlt-1 and sEng to predict PE in a high-risk group. Methods Non-fasting samples were analysed at 11 + 0–13 + 6 (V1) and 19 + 0–21 + 6 weeks (V2) ( n = 195). Logistic regression models were determined. Area under (AUC) the receiver operating characteristic (ROC) curve analysis was performed. The added value of biomarkers to clinical characteristics for PE prediction was quantified using integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices. Results Prevalence of PE was 12%. Lower concentrations of sFlt-1:PlGF (V1) and PlGF and PlGF:sEng (V2) were seen in women who developed PE. Controlling for baseline characteristics (V1), a doubling of sFlt-1 (pg/mL) (median 896.0, IQR 725.5–1097.0) and sFlt-1:PlGF (median 21.2, IQR 14.7–32.3) was associated with reduction in odds of PE (OR 0.20, 95% CI 0.06–0.65, P = 0.007 and OR 0.48, 95% CI 0.25–0.92, P = 0.04). Addition of sFlt-1 and sFlt-1:PlGF to baseline characteristics non-significantly improved AUC (0.74) (AUC 0.77, P = 0.40 and 0.76, P = 0.39). NRI and IDI analyses confirmed added clinical utility of sFlt-1 (NRI = 0.539, P = 0.01 and IDI = 0.052, P = 0.03). In V2, doubling of PlGF:sEng (median 71.9, IQR 47.0–102.8) was associated with reduction in the risk of PE (OR 0.56, 95% CI 0.35–0.98, P = 0.04). The addition of PlGF:sEng to baseline characteristics non-significantly improved AUC from 0.78 to 0.82 ( P = 0.25) and improved reclassification of cases (NRI = 0.682, P = 0.002). Conclusions Screening tests incorporating first trimester sFlt-1 and second trimester PlGF:sEng have potential to aid PE prediction in high-risk pregnancies.

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Section: Discussionmentioning

confidence: 86%

The role of biomarkers in predicting pre-eclampsia in high-risk women

et al. 2019

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“…They reported a PE detection rate of 50% with a FPR of 10% by using only maternal body mass index (BMI) and mean artery pressure at 34 weeks of pregnancy and a detection rate of 75% with the addition of UtA PI and more than 95% with the addition of PIGF and PAPP-A values (24). However, Diguisto et al (25) reported that the multivariate model adjusted according to 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). As a result, in a high-risk population, PlGF in the first trimester is useful for predicting PE, but neither sFlt-1 nor any UtA Doppler indices improved the prediction of PE (25).…”

Section: Discussionmentioning

confidence: 93%

“…However, Diguisto et al (25) reported that the multivariate model adjusted according to 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). As a result, in a high-risk population, PlGF in the first trimester is useful for predicting PE, but neither sFlt-1 nor any UtA Doppler indices improved the prediction of PE (25). Li et al (26) demonstrated that UtA PI at early secondtrimester was increased in pregnancies that developed PE (1.61±0.047 vs. 1.02±0.049, p<0.001).…”

Section: Discussionmentioning

confidence: 93%

Prediction of Preeclampsia by Uterine Artery Doppler Examination and Placental Growth Factor, Endoglin and Pregnancy-associated Plasma Protein Levels in Maternal Serum at 11-13+6 Pregnancy Week

Köpük¹,

Çakıroğlu²,

Ceylan³

et al. 2019

eamr

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We aimed to evaluate the prediction of preeclampsia by maternal serum pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PIGF), sEndoglin (sEng) and uterine artery Doppler examination. Methods: One hundred and ninety-three singleton pregnant women admitted to outpatient clinic at 11-13+6 weeks for first trimester combined screening test were included in the study. Maternal history was taken, and uterine artery Doppler examination and serum biomarker screening (PAPP-A, PIGF, sEndoglin) were conducted. The follow-up results of pregnancy were recorded. The study cohort was divided into two groups as "control" and "preeclampsia". Mann-Whitney U and chi-square tests were used for comparison of independent variables. Sensitivity and specificity for the predictive values of the significant parameters were calculated from ROC curves. Results: Of 193 women, 168 women (87%) were in the control group (group 1) and 25 women (12.9%) who developed preeclampsia were defined in the preeclampsia group. In preeclampsia group, 20 women (10.3%) with gestational hypertension and mild preeclampsia were defined as "group 2", and five women (2.5%) with severe preeclampsia and hemolysis, elevated liver enzymes, low platelet were defined as "group 3". Maternal serum PAPP-A, PIGF, sEng levels were not significantly different between preeclampsia group and control group, whereas uterine artery Doppler pulsatility index (PI) values were significantly higher in preeclampsia group (p=0.023). sEng levels were significantly higher in group 3 than those in group 2 (p=0.001). If uterine artery PI cutoff level was taken as >2.23 in ROC curve analysis, sensitivity was 42.31% and specificity was 82.10% for detecting preeclampsia. Conclusion: Maternal serum PAPP-A, PIGF and sEng were not effective in predicting preeclampsia. However, these markers can be used to distinguish between mild and severe preeclampsia. First trimester uterine artery Doppler examination is an effective screening method for predicting preeclampsia.

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“…Several studies have reported various proportions of occurrence of PE among high-risk pregnant women (14) . Diguisto et al (15) conducted a study aiming at evaluation of the accuracy of uterine artery Doppler in the first trimester for preeclampsia screening. In accordance to this study, they prospectively enrolled women at high risk of preeclampsia.…”

Section: Discussionmentioning

confidence: 99%

Screening of High-Risk Patient by Uterine Artery Doppler Analysis in The 1st Trimester to Predict Early Onset Pre-Eclampsia

Mohamed

Badawy

Ismail

2021

The Egyptian Journal of Hospital Medicine

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Background: Preeclampsia (PE) is still a major obstetrical problem world-wide. First trimester prediction of PE is of great clinical importance, as it would allow clinicians to focus on high-risk groups and initiate prophylactic medical treatment. The first stage of pre-eclampsia begins in the first trimester by impaired placentation. High-resistant spiral arteries can be detected from the 11 th week of gestation by uterine artery (UtA) Doppler examination. Objective: To assess the relationship between 1st trimester uterine artery pulsatility index (UtA PI) and the development of early onset PE. Patients and Methods: Prospective observational study was performed at Mansoura University Hospital. This study was conducted on 109 pregnant women who attended their routine antenatal care visits at the Outpatient Obstetrics and Gynecology Clinic of Mansoura University Hospital. Results: There were statistically high significant difference between both groups in the BMI (p = 0.003), and no statistically significant difference as regards the age, gravidity and gestational age (p > 0.05). Statistically significant difference was evident between two groups in the mean values of UtA PI (p = 0.028). The best cutoff value of UtA PI for the prediction of early onset preeclampsia was ≥ 2.03 with accuracy of 0.79, and that of BMI was ≥ 35 with accuracy of 0.93. Conclusion:This study revealed that first trimester uterine artery Doppler can be used as a reliable screening test for prediction of preeclampsia in high risk women. It is a reliable, noninvasive method of examining uteroplacental perfusion. Abnormal UA Doppler ultrasonography (elevated PI) in 11-14 weeks' gestation can predict pre-eclampsia.

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First trimester uterine artery Doppler, sFlt-1 and PlGF to predict preeclampsia in a high-risk population

Abstract: 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.

Cited by 18 publications

References 24 publications

The role of biomarkers in predicting pre-eclampsia in high-risk women

The role of biomarkers in predicting pre-eclampsia in high-risk women

Prediction of Preeclampsia by Uterine Artery Doppler Examination and Placental Growth Factor, Endoglin and Pregnancy-associated Plasma Protein Levels in Maternal Serum at 11-13+6 Pregnancy Week

Screening of High-Risk Patient by Uterine Artery Doppler Analysis in The 1st Trimester to Predict Early Onset Pre-Eclampsia

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