Department of Maternal-Fetal Medicine, Institute Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
Curr Opin Obstet Gynecol. 2011 Apr;23(2):65-71. doi: 10.1097/GCO.0b013e328344579c.
To provide a concise review of advances in prediction of preeclampsia, highlighting the most important and interesting articles among the many published within the past months, making a clear distinction between early and late clinical forms of the condition.
The performance of maternal levels of angiogenic factors to predict preeclampsia, especially early-onset preeclampsia, could be further improved by combining several markers and by evaluating the longitudinal changes between the first and second trimester. Combining first trimester angiogenic factors with maternal history, mean blood pressure and uterine artery Doppler achieves a detection rate of approximately 90% for an approximately 10% of false positives for early preeclampsia. The incorporation of parameters reflecting maternal vascular stiffness into multiparametric models in contingent strategies might result in fewer tests than concurrent screening, with similar prediction performance.
Combining several tests into multiparametric models results in the early identification of the vast majority of cases bound to develop early preeclampsia, which is the clinical form that most contributes to adverse maternal and perinatal outcome. This may allow more efficient allocation of resources according to the individual risk and the evaluation of prophylactic strategies in a selected subgroup of women.
提供子痫前期预测进展的简明综述，突出在过去几个月发表的众多文章中最重要和最有趣的文章，明确区分该疾病的早期和晚期临床形式。
通过结合多个标志物并评估第一和第二孕期之间的纵向变化，可以进一步提高母体血管生成因子水平预测子痫前期，尤其是早发型子痫前期的性能。将第一孕期血管生成因子与母体病史、平均血压和子宫动脉多普勒结合起来，对于早发性子痫前期，大约 10%的假阳性率可达到约 90%的检出率。在条件策略中将反映母体血管僵硬的参数纳入多参数模型中，可能会导致比并发筛查更少的检测，具有相似的预测性能。
将多项检测结合到多参数模型中可以早期识别绝大多数可能发生早发型子痫前期的病例，这是导致不良母婴和围产结局的主要临床形式。这可能根据个体风险更有效地分配资源，并在选定的妇女亚组中评估预防策略。
