Tripathi Vartika, Jaiswar S P, Deo Sujata, Shankhwar Pushplata
Department of Obstetrics and Gynecology, King George Medical University, Lucknow, India.
J Obstet Gynaecol India. 2019 Oct;69(Suppl 2):122-127. doi: 10.1007/s13224-018-1154-0. Epub 2018 Aug 1.
Preeclampsia is an important cause of maternal and perinatal morbidity and mortality. The pathophysiology of preeclampsia has been extensively studied. 2ME seems to maintain placental homeostasis necessary for appropriate cytotrophoblast invasion of the maternal deciduas. We plan this study to compare its value in the plasma of normotensive and preeclamptic women and studying its correlation with the severity indices of preeclampsia.
The aim of this study was to estimate plasma levels of 2ME in preeclamptic and normotensive pregnant women and correlate it with the severity in terms of clinical indices, laboratory investigations, and fetomaternal outcome.
This study was a case-control study conducted in KGMU, Lucknow, August 2015-2016. Sample size was 90 pregnant women including 30 normotensive, 30 non-severe preeclampsia, and 30 severe preeclampsia patients. Plasma 2ME levels were analyzed using ELISA kit and the outcome was compared in terms of systolic and diastolic blood pressure, proteinuria, liver and renal function tests, serum LDH, uric acid, plasma 2ME levels, and fetomaternal outcome.
There was a significant (= 0.0001) difference in 2ME plasma levels among the groups (normotensive, non severe and severe preeclampsia patients). 2ME plasma levels significantly negatively correlated with SBP ( = - 0.62, = 0.0001) and DBP ( = - 0.63, = 0.0001). With one-unit increase in SBP, 2ME will decrease by 2445.14 units, and in one-unit increase in DBP, 2ME will decrease by 1807.28 units. The sensitivity and specificity of 2ME for preeclampsia were found to be high.
It was seen that there was a statistically significant difference between plasma 2ME levels among the three groups. The ROC curve obtained showed that sensitivity was predicted to be 98.3%, specificity 76.7%, positive predictive value of 89.4%, negative predictive value of 95.8% and accuracy of 91.1%.
子痫前期是孕产妇和围产儿发病及死亡的重要原因。子痫前期的病理生理学已得到广泛研究。2ME似乎维持着细胞滋养层对母体蜕膜进行适当侵袭所必需的胎盘内环境稳定。我们计划开展本研究，比较其在血压正常和子痫前期女性血浆中的价值，并研究其与子痫前期严重程度指标的相关性。
本研究的目的是评估子痫前期和血压正常的孕妇血浆中2ME的水平，并将其与临床指标、实验室检查及母婴结局方面的严重程度相关联。
本研究是一项于2015年8月至2016年在勒克瑙的KGMU进行的病例对照研究。样本量为90名孕妇，包括30名血压正常者、30名非重度子痫前期患者和30名重度子痫前期患者。使用ELISA试剂盒分析血浆2ME水平，并比较收缩压和舒张压、蛋白尿、肝肾功能检查、血清乳酸脱氢酶、尿酸、血浆2ME水平及母婴结局方面的结果。
各组（血压正常者、非重度和重度子痫前期患者）之间2ME血浆水平存在显著差异（= 0.0001）。2ME血浆水平与收缩压（= -0.62，= 0.0001）和舒张压（= -0.63，= 0.0001）显著负相关。收缩压每升高一个单位，2ME将降低2445.14个单位，舒张压每升高一个单位，2ME将降低1807.28个单位。发现2ME对子痫前期的敏感性和特异性较高。
可以看出，三组之间血浆2ME水平存在统计学显著差异。所得的ROC曲线显示，预测敏感性为98.3%，特异性为76.7%，阳性预测值为89.4%，阴性预测值为95.8%，准确性为91.1%。
