First trimester screening for preeclampsia-A prospective observational study

Authors

  • Krishnaveni Muthiah Department of Obstetrics and Gynecololgy, KMCHIHSR, Coimbatore, Tamilnadu, India
  • Prema Nalligounder Department of Obstetrics and Gynecololgy, KMCHIHSR, Coimbatore, Tamilnadu, India.
  • Sudhakaran R Department of Obstetrics and Gynecololgy, KMCHIHSR, Coimbatore, Tamilnadu, India.
  • Renukadevi R Department of Obstetrics and Gynecololgy, KMCHIHSR, Coimbatore, Tamilnadu, India.

Keywords:

Mean arterial pressure, Pregnancy associated plasma protein-A, Preeclampsia, Uterine artery pulsatility index

Abstract

Aims: To evaluate the effectiveness of mean arterial pressure (MAP), pregnancy associated plasma protein-A (PAPP-A) and mean uterine artery doppler pulsatility index (UtPI), individually and in combination, as screening tests to predict the development of preeclampsia, its severity and onset.

Methods: A prospective observational study was done in 800 pregnant women attending the antenatal clinic in a tertiary care centre between 11+0 to 13+6 weeks. Their MAP, uterine artery doppler and serum PAPP-A were measured and were followed till delivery for the development of preeclampsia, its severity and time of onset. The sensitivity, specificity, positive predictive value and negative predictive value were calculated for these screening tests, individually and in combination. Chi-square test was used to test the statistical significance. A p value <0.05 was considered statistically significant.

Results: A MAP of ≥ 89 mmHg was not strongly associated with the development of preeclampsia. However, mean UtPI ≥ 95th percentile was strongly associated with the development of preeclampsia with specificity of 95.53% and sensitivity of 40.98 %. A value of PAPP-A less than 5th percentile was strongly associated with the development of preeclampsia. By combining MAP and mean UtPI, positive results were associated with the development of preeclampsia with sensitivity of 18.03% and specificity of 99.45 %. With MAP+Mean UtPI+PAPP-A, positive tests results were strongly associated with the development of preeclampsia with specificity of 100% and sensitivity of 11.47%.

Conclusion: The specificity and positive predictive value of the tests were increased with the use of combination of markers than individual markers.

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Published

2023-09-25

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Section

Original Articles