Comparison of preeclampsia and fetal growth restriction screenings at first trimester in a high-risk population

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Romero_Infante_Ximena_Carolina_2020.pdf.pdf (1012.9 KB)

Fecha

2021

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Publicado en

Journal of Obstetrics and Gynaecology Research, 1447-0756, Vol. 47, Nro. 2, 2021, p. 765-773

Publicado por

Japan Society of Obstetrics and Gynecology
John Wiley & Sons, Inc

URI

https://hdl.handle.net/20.500.12495/5438

URL de la fuente

https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/jog.14605

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Abstract

Aim To compare the sensitivity and specificity of screening for preeclampsia and FGR including maternal characteristics, mean arterial blood pressure and uterine artery pulsatility index and the combined screening, which adds biochemical markers, such as placental growth factor (PlGF) and pregnancy‐associated plasma protein‐A (PAPP‐A), in a sample of high risk population for hypertensive disorders. Methods This is a prospective study with 527 singleton pregnancies at 11–14 weeks of gestation. Maternal characteristics, biochemical and biophysical markers were studied to determine the development of preeclampsia and FGR by using receiver operating characteristic curves. Results For preeclampsia, screening, including sociodemographic data plus biophysical markers, had a sensitivity and specificity of 70.3% (CI% 64.3–75.2) and 93.8% (CI% 90.9–96.8), respectively. Combined screening, which includes sociodemographic data, biophysical (mean blood pressure and uterine artery pulsatility index) and biochemical markers (PlGF and PAPP‐A), increased sensitivity and specificity up to 85.5% (CI% 80.2–90.3) and 96.3% (CI% 91.4–98.9), respectively. For FGR, sociodemographic data plus biophysical markers had a sensitivity and specificity of 57.8% (CI% 50.1–63.4) and 80.1% (CI% 74.3–85.9), respectively. Combined screening increased sensitivity and specificity up to 67.2% (CI% 52.1–71.3) and 82.7% (CI% 75.2–90.1), respectively. Conclusion Combined screening for preeclampsia and FGR at 11 to 14 weeks of gestation, which includes maternal characteristics, mean blood pressure, uterine artery pulsatility index, PAPP‐A and PlGF, has higher sensitivity and specificity than other screening options. Therefore, considering all these variables during screening is recommended for a superior opportunity of identifying pregnant women in risk for preeclampsia and FGR, especially in a high‐risk population.

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Keywords

Fetal growth restriction, Preeclampsia, Risk factors, Sensitivity, Specificity

Temáticas

Hipertensión inducida en el embarazo
Retardo del crecimiento fetal
Enfermedades fetales

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