Department of Obstetrics and Gynecology, University of Liège, Liège, Belgium.
Ultrasound Obstet Gynecol. 2010 Jun;35(6):680-7. doi: 10.1002/uog.7621.
To examine the performance of screening for pre-eclampsia (PE) by a combination of maternal factors, soluble endoglin (sEng), pregnancy associated plasma protein-A (PAPP-A), placental growth factor (PlGF) and uterine artery lowest pulsatility index (L-PI) at 11-13 weeks' gestation.
Uterine artery L-PI, sEng, PAPP-A and PlGF were measured at 11-13 weeks in 90 singleton pregnancies that subsequently developed PE, including 30 that required delivery before 34 weeks (early PE) and 60 with late PE, and 180 unaffected controls. Screening performance for PE by maternal factors, sEng, PAPP-A, PlGF and uterine artery L-PI and their combinations was determined.
In early PE, compared to controls, plasma sEng and uterine L-PI were significantly increased and serum PAPP-A and PlGF were decreased. In late PE, compared to controls, serum PlGF was decreased and uterine L-PI was increased but plasma sEng and serum PAPP-A were not significantly different. In screening for early PE, the detection rate for a 10% false-positive rate was 46.7% for sEng alone and 96.3% for a combination of maternal factors, sEng, PlGF and uterine artery L-PI.
Effective screening for early PE can be provided by a combination of maternal factors, sEng, PlGF and uterine artery L-PI at 11-13 weeks' gestation.
探讨在 11-13 孕周时，联合母体因素、可溶性内皮糖蛋白（sEng）、妊娠相关血浆蛋白-A（PAPP-A）、胎盘生长因子（PlGF）和子宫动脉最低搏动指数（L-PI）筛查子痫前期（PE）的效能。
在 90 例单胎妊娠中测量了 11-13 孕周的子宫动脉 L-PI、sEng、PAPP-A 和 PlGF，这些妊娠随后发生了 PE，包括 30 例需要在 34 周前分娩（早发性 PE）和 60 例晚发性 PE，以及 180 例未受影响的对照组。通过母体因素、sEng、PAPP-A、PlGF 和子宫动脉 L-PI 及其组合来确定对 PE 的筛查性能。
在早发性 PE 中，与对照组相比，血浆 sEng 和子宫 L-PI 显著升高，血清 PAPP-A 和 PlGF 降低。在晚发性 PE 中，与对照组相比，血清 PlGF 降低，子宫 L-PI 升高，但血浆 sEng 和血清 PAPP-A 无显著差异。在筛查早发性 PE 时，sEng 单独检测的假阳性率为 10%时的检出率为 46.7%，而母体因素、sEng、PlGF 和子宫动脉 L-PI 联合检测的检出率为 96.3%。
在 11-13 孕周时，联合母体因素、sEng、PlGF 和子宫动脉 L-PI 可以有效筛查早发性 PE。
