July - September 2013, Volume 9, Issue 3

Mehaney D, Shehata M., Elsherbini M., Elkomy R

The Potential Role of First Trimester Maternal Serum PP13 and Second-Trimester Uterine Artery Doppler Pulsatility Index as Markers of Pre-eclampsia among High Risk Egyptian Pregnant Females

Acta Endo (Buc) 2013, 9 (3): 429-438
doi: 10.4183/aeb.2013.429

Abstract. Preeclampsia is a widespread vasospasm and vascular endothelial dysfunction that usually occurs after 20 weeks gestation. Uterine artery Doppler is a good sensitive predictor. PP13 (as a chemical predictor) was claimed to provide similar results. Objective. To evaluate whether first trimester maternal serum placenta protein 13 (PP13) and the second trimester uterine artery Doppler pulsatility index can predict pre-eclampsia among high risk Egyptian pregnant females. Design. The study took place in obstetric clinic of Kasr Elaini Hospital (Faculty of Medicine - Cairo University) in the period October 2011 - August 2012. Subjects and Methods. The study included 59 pregnant women (11- 13 weeks), 34 normal controls and 25 women at increased risk of developing pre-eclampsia. PP13 was assayed using enzyme-linked immunosorbent assay. Uterine artery Doppler flow velocimetry was done at 22–24 weeks to measure the mean pulsatility index (PI). PP13 multiples of median (MoM) were calculated.PP13 and Uterine artery Doppler PI were compared between women who developed pre-eclampsia and controls. Results. Levels of PP13 were not found to differ between control and affected pregnancies. PP13 MoMs for controls and pre-eclampsia cases were 1.000 (0.516) and 1.7200 (0.851), respectively (P=0.4). PI was significantly higher in affected cases 1.62(0.2) compared to controls 1.24(0.2) (P <0.001). Conclusion. Screening test based only on maternal history or PP13 testing is inefficient in predicting preeclampsia in high risk females. Abnormal uterine artery Doppler velocimetry between 22 and 24 weeks of gestation is still the best test for identification of patients destined to develop preeclampsia.

Keywords: Pre-eclampsia, Uterine artery Doppler, PP13.

Correspondence: Moutaz Elsherbini MD, Faculty of Medicine - Cairo University, Gyn. & Obs., Kasr Elaini, Qasr Elaini Street, Cairo, 11441, Egypt, E-mail: mizosherbini@yahoo.com