European Journal of Molecular & Clinical Medicine

Abstract

Introduction: Preeclampsia is a multisystem disorder and is a major contributor of maternal and perinatal morbidity and mortality. Identifying women, who are at risk is important to prompt gestational management. Uterine artery waveform and biomarkers like pregnancy-associated plasma protein-A (PAPP-A) may reflect the pathophysiology of preeclampsia.
Aim: We aim to find out whether abnormal uterine artery pulsatility index (PI) and low serum PAPP-A in the first trimester can be used to predict preeclampsia.
Material And Methods: Antenatal women at 11-13⁺⁶ weeks of gestation visiting Sri Guru Ram Das Universty Of Health And science, Amritsar were enrolled after informed consent. Uterine artery Doppler was done with the early anomaly scan at 11-13⁺⁶ weeks. Serum levels of PAPP-A were analyzed. The women were followed up at intervals up to delivery. Incidence of preeclampsia was noted.
RESULTS: The incidence of preeclampsia was 26%. The mean uterine artery PI among those who developed preeclampsia was 2.03, which was significantly higher than the unaffected group (p=0.001). The first-trimester uterine artery PI as a screening tool showed a sensitivity of 84.67% and specificity of 75.68 % .The mean PAPP-A MoM of the affected group was 0.91 which was lower than the unaffected group (p=0.028). The first trimester PAPP-A as a screening tool showed a sensitivity of 15.38%, specificity of 91.89%.
Conclusion: Both the tests were concluded to be good predictors of preeclampsia. Identification of high-risk factors, screening, and surveillance are  important for timely  prediction of  preeclampsia and initiation of preventive therapy.