Authors: Franz Bahlmann Ammar Al Naimi
Publish Date: 2016/06/02
Volume: 294, Issue: 6, Pages: 1133-1139
Abstract
The aim of this study is to assess the value of the angiogenic factors for diagnosing preeclampsia and predicting the severity of manifestation A secondary aim is assessing the combination of the uterine artery Doppler with the angiogenic factors for improving the diagnostic powerThis is a prospective single center study in a tertiary referral hospital This study includes 728 individual patients Inclusion criteria were singleton pregnancies a referral to the hospital with suspicion of preeclampsia and any one or combination of the following symptoms headache upper abdominal pain edema and hypertension Patients with complications that would affect the course of the pregnancy such as placenta praevia premature preterm rupture of membranes breech presentation and fetal chromosomal or structural anomalies were excluded from the study Blood samples collection and uterine artery Doppler ultrasound were performed at time of recruitment The differences in sFlt1 PlGF and their quotient among normal collective and patients with preeclampsia were analyzed Doppler ultrasound was performed by one of four highly qualified sonographers Wilcoxon–Mann–Whitney U test Spearman’s rank correlation receiver operating characteristic curves Chisquare test and logistic regression were used in the analysisA total of 1003 individual samples for the angiogenic factors were included in the analysis 584 out of the recruited 728 patients had followup data with delivery information at the study hospital Patients with preeclampsia show a significant increase in sFlt1 which directly correlate with the increased severity of manifestation Spearman’s ρ 049 The sFlt1 cutoff value of 5424 pg/ml confirms preeclampsia with 837 sensitivity 681 specificity and 24 misclassification rate Preeclampsia patients also show a significant decrease in PlGF which negatively correlates with the increased severity of manifestation Spearman’s ρ −039 A PlGF cutoff value of 118 pg/ml confirms preeclampsia with 476 sensitivity 714 specificity and 27 misclassification rate Logistic regression shows that a combination of the quotient from sFlt1/PlGF with notching and uterine artery PI provides a valid model for diagnosing preeclampsia with a diagnostic power of 744 The study confirms the use of the sFlt1 and PlGF for diagnosing preeclampsia It also shows their significance in differentiating between different categories of preeclampsia according to severity This study shows that the use of angiogenic factors in combination with ultrasound findings provides valid models for confirming preeclampsiaAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards
Keywords: