First trimester prediction of preeclampsia based on maternal factors, biomarkers and 3D power doppler of placental bed vascularization
Objective. To develop the best screening model for preeclampsia (PE) based on maternal characteristics, biomarkers with 3D power Doppler of placental bed vascularization. Materials and methods. A prospective nonintervention cohort study. Patients who presented for combined screening were measured/recorded at 11-13+6 weeks maternal characteristics, mean arterial blood pressure (MAP), uterine artery Doppler pulsatility indices (UtA-PI), 3D power Doppler of placental bed vascularization indices (PB-VI) and VOCAL technology, maternal serum placental growth factor (PlGF) Logistic regression analysis was used to predict PE. Results. We screened 5157 pregnant women of whom 3424 (66,4%) were available for analysis. In all, 102 (3,0%) developed PE, with 29 (0,9%) having early-onset PE and 73 (2,1%) having late-onset PE. The best model for early PE (n=29) and late PE (n=73) included maternal risk factors, MAP, PlGF and PB-VI achieving detection rates of 89,7% (AUC 0,941; CI: 0,944-0,978) and 50,7% (AUC 0,833; 95% CI: 0,800-0,863) for 10% of false-positive rates. There was no significant improvement when adding PAPP-A, uterine artery Doppler values, or both. Conclusions. Preeclampsia can be predicted with high accuracy in low risk population by combined algorithms with vascularization indices of placental bed using 3D power Doppler angiography. Among Doppler parameters as PB-VI and UtA-PI, improve the prediction for early and late PE, and PB-VI vs UtA-PI detects significantly higher rates of early PE. The data need confirmation in larger studies.Kholin A.M., Muminova K.T., Nagoev T.M., Khodzaeva Z.S., Gus A.I.
Keywords
preeclampsia
first trimester screening
prediction
three-dimensional power Doppler
uterine artery Doppler
placental bed
References
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Received 30.09.2017
Accepted 27.10.2017
About the Authors
Alexey Kholin, M.D., Clinical & Research Fellow, Department of Maternal Fetal Medicine, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: a_kholin@oparina4.ruKamilla Muminova, M.D. Clinical Fellow, Department of Maternal Fetal Medicine, Federal Research Center for Obstetrics, Gynecology & Perinatology, Ministry of healthcare of the Russian Federation. National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4
Nagoev Temirlan Mukhamedovich, resident trainee, National Medical Research Center for Obstetrics, Gynecology and Perinatology named
after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4
Zulfiya Khodzhaeva, M.D., Ph.D., Professor, Principal Investigator, Department of Maternal-Fetal Medicine, National Medical Research Center for Obstetrics,
Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4
Alexander Gus, M.D., Ph.D., Head of Ultrasound Department, National Medical Research Center for Obstetrics, Gynecology and Perinatology named
after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4
For citations: Kholin A.M., Muminova K.T., Nagoev T.M., Khodzaeva Z.S., Gus A.I. First trimester prediction of preeclampsia based on maternal factors, biomarkers and 3D power doppler of placental bed vascularization. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (8): 56-65. (in Russian)
https://dx.doi.org/10.18565/aig.2018.8.56-65
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