scholarly journals Early Prediction of Preeclampsia

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Leona C. Poon ◽  
Kypros H. Nicolaides
Keyword(s):  
Early Onset ◽  
False Positive Rate ◽  
Protein A ◽  
First Trimester ◽  
Maternal Serum ◽  
Uterine Artery Doppler ◽  
Maternal Risk ◽  
Positive Rate ◽  
First Trimester Of Pregnancy ◽  
Early Onset Preeclampsia

Effective screening for the development of early onset preeclampsia (PE) can be provided in the first-trimester of pregnancy. Screening by a combination of maternal risk factors, uterine artery Doppler, mean arterial pressure, maternal serum pregnancy-associated plasma protein-A, and placental growth factor can identify about 95% of cases of early onset PE for a false-positive rate of 10%.

scholarly journals Combination of PAPPA, fhCGβ, AFP, PIGF, sTNFR1, and Maternal Characteristics in Prediction of Early-onset Preeclampsia

2015 ◽  
Vol 9 ◽  
pp. CMRH.S21865 ◽  
Author(s):  
Anna Yliniemi ◽  
Kaarin Makikallio ◽  
Teemu Korpimaki ◽  
Heikki Kouru ◽  
Jaana Marttala ◽  
...  
Keyword(s):  
Early Onset ◽  
Smoking Status ◽  
False Positive Rate ◽  
Protein A ◽  
Tumor Necrosis Factor Receptor ◽  
Serum Levels ◽  
First Trimester ◽  
Maternal Serum ◽  
Maternal Characteristics ◽  
Early Onset Preeclampsia

Objective To evaluate the efficacy of first-trimester markers–-pregnancy-associated plasma protein A (PAPPA), free human chorionic gonadotropin β (fhCGβ), alpha-fetoprotein (AFP), placental growth factor (PlGF), and soluble tumor necrosis factor receptor-1 (sTNFR1) together with maternal characteristics (MC) for prediction of early-onset preeclampsia (EOPE). Methods During 2005-2010, the abovementioned biomarkers were analyzed with logistic regression analysis in 64 EOPE and 752 control subjects to determine whether these biomarkers separately and in combination with MC would predict development of EOPE. Results PAPPA, fhCGβ, and PlGF levels were lower, whereas AFP and sTNFR1 levels were higher in mothers with EOPE compared to controls. The combination of all markers with MC (age, weight, and smoking status) detected 48% of the mothers with EOPE, with a 10% false-positive rate (FPR). Conclusions First-trimester maternal serum levels of PAPPA, fhCGβ, AFP, PlGF, and sTNFR1, together with MC, are predictive of development of subsequent EOPE. These markers, along with MC, form a suitable panel for predicting EOPE.

scholarly journals Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 182
Author(s):  
Max Mönckeberg ◽  
Valentina Arias ◽  
Rosario Fuenzalida ◽  
Santiago Álvarez ◽  
Victoria Toro ◽  
...  
Keyword(s):  
High Risk ◽  
Early Onset ◽  
Diagnostic Performance ◽  
Uterine Artery ◽  
Late Onset ◽  
First Trimester ◽  
Maternal Risk ◽  
Predictive Algorithm ◽  
First Trimester Of Pregnancy ◽  
Early Onset Preeclampsia

Preeclampsia is a pregnancy-specific disorder defined by new onset of hypertension and proteinuria after 20 weeks of gestation. The early detection of patients at risk of developing preeclampsia is crucial, however, predictive models are still controversial. We aim to evaluate the diagnostic performance of a predictive algorithm in the first trimester of pregnancy, in order to identify patients that will subsequently develop preeclampsia, and to study the effect of aspirin on reducing the rate of this complication in patients classified as high risk by this algorithm. A retrospective cohort including 1132 patients attending prenatal care at Clínica Dávila in Santiago, Chile, was conceived. The risk of developing preeclampsia (early and late onset) was calculated using algorithms previously described by Plasencia et al. Patients classified as high risk, in the first trimester of pregnancy, by these algorithms, were candidates to receive 100 mg/daily aspirin as prophylaxis at the discretion of the attending physician. The overall incidence of preeclampsia in this cohort was 3.5% (40/1132), and the model for early onset preeclampsia prediction detected 33% of patients with early onset preeclampsia. Among the 105 patients considered at high risk of developing preeclampsia, 56 received aspirin and 49 patients did not. Among those who received aspirin, 12% (7/56) developed preeclampsia, which is equal to the rate of preeclampsia (12% (6/49)) of those who did not receive this medication. Therefore, the diagnostic performance of an algorithm combining uterine artery Doppler and maternal factors in the first trimester predicted only one third of patients that developed preeclampsia. Among those considered at high risk for developing the disease using this algorithm, aspirin did not change the incidence of preeclampsia, however, this could be due either to the small study sample size or the type of the study, a retrospective, non-interventional cohort study.

scholarly journals Early changes of placenta-derived messenger RNA in maternal plasma – potential value for preeclampsia prediction?

2015 ◽  
Vol 23 (4) ◽  
pp. 431-438
Author(s):  
Sebastian Surugiu ◽  
Adina Chis ◽  
Codruta Mare ◽  
Horea Matei ◽  
Florin Stamatian
Keyword(s):  
Messenger Rna ◽  
False Positive Rate ◽  
Protein A ◽  
First Trimester ◽  
Maternal Plasma ◽  
Plasma Potential ◽  
Multivariate Model ◽  
Clinical Onset ◽  
Positive Rate ◽  
First Trimester Of Pregnancy

Abstract Objective: the pourpose of the study was to determine if there are any differences between placenta derived plasmatic levels of messenger RNA in normal and future preeclamptic pregnancies and if these placental transcripts can predict preeclampsia long before clinical onset Study design: we compared plasmatic expression of two placental transcripts from 12 women who ultimately developed preeclampsia with 224 controlled subjects, at the end of the first trimester of pregnancy. After multiplse-of-the-median conversion of markers we developed a multivariate model using logistic regression to determine preeclampsia risk. Results: we found lower multiples of the median values for both placental transcripts (mRNA corresponding to placental growth factor and pregnancy associated plasmatic protein A) in cases who ultimately developed preeclampsia and the multivariate model we obtained offered a preeclampsia detection rate of 75% at 10% false positive rate. Conclusion: specific early changes of placenta-derived messenger RNA could be used as preeclampsia predictors.

scholarly journals False Positive Values of Biomarkers of Prenatal Screening on Chromosomopathy as Indicators of a Risky Pregnancy

2011 ◽  
Vol 30 (2) ◽  
pp. 126-130 ◽  
Author(s):  
Jasmina Durković ◽  
Luka Anđelić ◽  
Bojana Mandić ◽  
Denis Lazar
Keyword(s):  
Genetic Screening ◽  
False Positive ◽  
Prenatal Screening ◽  
Protein A ◽  
First Trimester ◽  
Maternal Serum ◽  
Fetal Hypoxia ◽  
Beta Hcg ◽  
First Trimester Of Pregnancy ◽  
Fetal Karyotype

False Positive Values of Biomarkers of Prenatal Screening on Chromosomopathy as Indicators of a Risky PregnancyGenetic screening on chromosomopathy has been performed on 2000 pregnant women in their first trimester of pregnancy by determining Pregnancy associated plasma protein-A and free-beta HCG biomarkers in maternal serum. After obtaining a normal fetal karyotype, the pathological values of the biomarkers have been correlated with other pregnancy disorders, and the possible causes of the positive genetic screening have been tested. 340 false positive biomarkers (17%) have been detected. The increased free-beta HCG (48.24%) had a significant influence. A significant correlation (p > 0.01) between the increased free-beta HCG and bleeding during pregnancy has been established. Complications occurred in 78.52% pregnancies with pathological biomarkers, MISSed in 13.82%, miscarriages in 10.88%, induced pregnancy terminations caused by fetal anomalies in 8.82% and births with disturbed fetal vitality in 45%. The research results have shown a significant correlation (p > 0.01) between the increased value of the free-beta HCG biomarkers and fetal hypoxia. The false positive genetic screening, caused by the increased free-beta HCG, can indicate placental dysfunction and fetal vitality disruption.

scholarly journals First Trimester Biochemical Screening for Trisomy 21: The Role of Free Beta hCG, Alpha Fetoprotein and Pregnancy Associated Plasma Protein A

1994 ◽  
Vol 31 (5) ◽  
pp. 447-454 ◽  
Author(s):  
K Spencer ◽  
D A Aitken ◽  
J A Crossley ◽  
G McCaw ◽  
E Berry ◽  
...  
Keyword(s):  
Chorionic Gonadotropin ◽  
Plasma Protein ◽  
Human Chorionic Gonadotropin ◽  
Trisomy 21 ◽  
False Positive Rate ◽  
Protein A ◽  
First Trimester ◽  
Serum Markers ◽  
Maternal Serum ◽  
Detection Rates

The potential efficacy of screening for trisomy 21 in the first trimester, using maternal serum markers α fetoprotein, free β human chorionic gonadotropin, unconjugated oestriol and pregnancy associated plasma protein A, was studied in an unselected population of women between the seventh and fourteenth week of gestation. Using a combination of α fetoprotein and free β human chorionic gonadotropin, 53% of affected pregnancies could be identified at a false positive rate of 5%. Unconjugated oestriol and pregnancy associated plasma protein A levels were lower in cases of trisomy 21, but their inclusion with other markers did not significantly improve detection rate. Monitoring the same pregnancies also in the second trimester showed that screening in the first trimester identified the same cases as in the second. We conclude that first trimester screening using free β human chorionic gonadotropin and α fetoprotein, is a viable possibility and will lead to detection rates in excess of 50%. Prospective studies are needed to confirm these observations.

scholarly journals Uterine Artery Doppler in the Prediction of Preeclampsia and Adverse Pregnancy Outcome

2010 ◽  
Vol 4 (2) ◽  
pp. 117-122
Author(s):  
George Daskalakis ◽  
Aris Antsaklis
Keyword(s):  
Pregnancy Outcome ◽  
Uterine Artery ◽  
Adverse Pregnancy Outcome ◽  
False Positive Rate ◽  
First Trimester ◽  
Maternal Serum ◽  
Uterine Artery Doppler ◽  
Mortality And Morbidity ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Preeclampsia and fetal growth restriction are major causes of perinatal mortality and morbidity. Several studies have shown that a generalized endothelial dysfunction is associated with these complications. Clinical trials have shown that pregnant women who demonstrate high resistance in uteroplacental blood flow are at higher risk for preeclampsia. Uterine artery Doppler studies both in the second and the first trimester can predict pregnancies at increased risk of the complications of impaired placentation. The sensitivity for predicting severe preeclampsia ranges between 80 and 90% for a false positive rate of 5 to 7%. Uterine artery Doppler screening at 20 to 24 weeks’ gestation is superior to first trimester screening, and appears to fulfill the requirements for a worthwhile screening test. Further research is needed to better assess the value of various combinations of uterine artery Doppler and maternal serum markers, for the prediction of adverse pregnancy outcome.

Performance characteristics of Elecsys free βhCG and PAPP-A for first trimester trisomy 21 risk assessment in gestational weeks 8+0 to 14+0

2016 ◽  
Vol 0 (0) ◽  
Author(s):  
Niels Tørring ◽  
Carlos Aulesa ◽  
Bernd Eiben ◽  
Mª José Ferri ◽  
Kypros H. Nicolaides ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Trisomy 21 ◽  
False Positive Rate ◽  
Protein A ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Serological Markers ◽  
Cross Sectional ◽  
Positive Rate ◽  
Technical Validation

AbstractScreening for fetal trisomy 21 (T21) in the first trimester includes analysis of the serological markers pregnancy-associated plasma protein A (PAPP-A) and free β-choriogonadotropin (free βhCG). With the recent launch of these assays on the cobas e and Elecsys platforms, we investigated their clinical and analytical performance.We conducted a multicenter study in 5397 pregnancies including 108 cross-sectional collected repository cases with verified fetal T21 at 8–14 weeks of gestation. A technical validation of the Roche ElecsysThe imprecision of the Elecsys free βhCG and PAPP-A assays was between 1.0% and 2.8%, and both assays showed correlation to Kryptor (free βhCG 0.981; PAPP-A 0.987), AutoDELFIA (free βhCG 0.995; PAPP-A 0.979) and IMMULITE assays (free βhCG 0.983; PAPP-A 0.983). With a cut off at 1:300 the overall sensitivity of the screening including nuchal translucency reached 94% for a 3% false positive rate.The Roche Elecsys free βhCG and PAPP-A are suitable and reliable assays for first trimester T21 risk assessment. Both assays were approved and recommended by the FMF.

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