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Clinical and Experimental Obstetrics & Gynecology  2017, Vol. 44 Issue (6): 851-855    DOI: 10.12891/ceog3534.2017
Original Research Previous articles | Next articles
Prediction of preeclampsia using extreme first-trimester PAPP-A, free βhCG and uterine artery Doppler in resource limited settings
R. Lukic1, *(), M. Djukic1, I. Soldatovic2, N. Karadzov Orlic1, D. Ardalic1, G. Dragovic3, Z. Mikovic1
1 Gynecology and Obstetrics Clinic "Narodni Front", School of Medicine, University of Belgrade, Belgrade, Serbia
2 Institute for Biomedical Statistics, School of Medicine, University of Belgrade, Belgrade, Serbia
3 Institute for Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, Belgrade, Serbia
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Abstract  
Purpose of investigation: The objective of this study was to predict preeclampsia using extreme-low first-trimester pregnancy-associated- plasma-protein-A-(PAPP-A), extreme-low free-beta-human-chorionic-gonadotropin-(free-βhCG)-levels, and extreme-high pulsatility- index (PI) of uterine arteries, as single and combined predictors for preeclampsia development in resource-limited-settings. Materials and Methods: First-trimester screening for PAPP A, free-βhCG, and PI was performed between 11-13+6 gestation-weeks in nulliparous, normotensive women with singleton pregnancy with extremely-low PAPP-A (PAPP-A ≤ 0.52 MoM), extremely-low free- βhCG (free-βhCG ≤ 0.56 MoM) and extremely-high PI (≥ 2.52). Results: Of 85 pregnant women, 14 (16.5%) developed preeclampsia. PAPP-A ≤ 0.52 MoM and PI ≥ 2.52, as a single categorical variables, found to be with high OR for preeclampsia-development (OR = 7.07, 95% CI = 0.873-57.204, p = 0.067; OR = 5.098, 95% CI = 0.625-41.575, p = 0.128, respectively). The ROC-curve identified PAPP-A and PI as continuous variables to be significant predictors of preeclampsia (AUC = 0.864, 95% CI = 0.750-0.978, p = 0.000; AUC = 0.762, 95% CI = 0.598-0.925, p = 0.002, respectively). A prediction model for preeclampsia including PAPP-A ≤ 0.52 MoM + PI ≥ 2.52 was found to be significantly associated with preeclampsia (p = 0.027). Conclusion: The present study suggests that the firsttrimester extreme low-PAPP-A and increased Doppler-PI levels have significant predictive capability for preeclampsia.
Key words:  Preeclampsia prediction      First trimester      Resource limited settings     
Published:  10 December 2017     
*Corresponding Author(s):  R. LUKIC     E-mail:  reljalu@gmail.com

Cite this article: 

R. Lukic, M. Djukic, I. Soldatovic, N. Karadzov Orlic, D. Ardalic, G. Dragovic, Z. Mikovic. Prediction of preeclampsia using extreme first-trimester PAPP-A, free βhCG and uterine artery Doppler in resource limited settings. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(6): 851-855.

URL: 

https://ceog.imrpress.com/EN/10.12891/ceog3534.2017     OR     https://ceog.imrpress.com/EN/Y2017/V44/I6/851

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