Plasma SerpinA5 in conjunction with uterine artery pulsatility index and clinical risk factor for the early prediction of preeclampsia

Object This study aimed to combine plasma protein SerpinA5 with uterine artery doppler ultrasound and clinical risk factor during the first trimester for prediction of preeclampsia. Methods and materials This study was a nested cohort study and was divided into the screening set and developing set. The plasma was collected during the first trimester (11+0–13+6 weeks), at the same time, UtA-PI was detected and recorded with four-dimensional color Doppler ultrasound. These pregnancies were followed up until after delivery. The plasma proteins were examined using ultra-performance liquid chromatography–mass spectrometry (UPLC-MS) and enzyme linked immunosorbent assay (ELISA). Placental samples preserved after delivery were analysed by immunohistochemistry. Clinical risk factors were obtained from medical records or antenatal questionnaires. Upregulation or downregulation of SerpinA5 expression in TEV-1 cells was performed to investigate the role of SerpinA5 in trophoblasts invasion. Results We demonstrated that SerpinA5 levels were greater not only in preeclampsia placental tissue but also in plasma (both p<0.05), and we found that SerpinA5 may interfere with trophoblastic cell invasion by inhibiting MSP. SerpinA5 may be a potential predictor of preeclampsia. What is more, the sensitivity and specificity of predictive power were strengthened when plasma SerpinA5 was combined with UtA-PI and pre-pregnancy BMI & family history of PE for prediction of preeclampsia. Conclusion These findings showed that placenta-derived plasma SerpinA5 may be a novel biomarker for preeclampsia, which together with uterine artery Doppler ultrasound and clinical risk factor can more effectively predict preeclampsia.

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Evaluation of 7 Serum Biomarkers and Uterine Artery Doppler Ultrasound for First-Trimester Prediction of Preeclampsia: A Systematic Review

Obstetrical & Gynecological Survey ◽

10.1097/ogx.0b013e3182227027 ◽

2011 ◽

Vol 66 (4) ◽

pp. 225-239 ◽

Cited By ~ 118

Author(s):

Sylwia Kuc ◽

Esther J. Wortelboer ◽

Bas B. van Rijn ◽

Arie Franx ◽

Gerard H. A. Visser ◽

...

Keyword(s):

Systematic Review ◽

Doppler Ultrasound ◽

Uterine Artery ◽

First Trimester ◽

Serum Biomarkers ◽

Uterine Artery Doppler

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Serum hypoxia-inducible factor-1α and uterine artery Doppler ultrasound during the first trimester for prediction of preeclampsia

Scientific Reports ◽

10.1038/s41598-021-86073-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Wasinee Tianthong ◽

Vorapong Phupong

Keyword(s):

Pregnant Women ◽

Doppler Ultrasound ◽

Predictive Value ◽

Uterine Artery ◽

Hypoxia Inducible Factor ◽

First Trimester ◽

Singleton Pregnancy ◽

Uterine Artery Doppler ◽

Hypoxia Inducible Factor 1Α ◽

Sensitivity Specificity

AbstractThe objective of this study was to determine the predictive value of serum hypoxia-inducible factor-1α (HIF-1α) combined with uterine artery Doppler in singleton pregnancy during 11–13+6 weeks of gestation for preeclampsia. This prospective observational study was conducted in singleton pregnant women at 11–13+6 weeks of gestation who visited the King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University for antenatal care between February 2019 and May 2020. Serum HIF-1α levels and uterine artery Doppler ultrasound were performed. Pregnancy outcomes were recorded. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these tests at the optimal cut-off values were determined to predict preeclampsia. A total of 385 participants were analyzed. Of these, 31 cases had preeclampsia (8.1%), and 6 cases of them had early-onset preeclampsia (1.6%). Preeclamptic women had significantly higher serum HIF-1α levels than normal pregnant women (median 1315.2 pg/ml vs. 699.5 pg/ml, p < 0.001). There was no difference in the mean pulsatility (PI) of the uterine artery. Serum HIF-1α levels were higher than 1.45 multiple of median for the gestational age as a cut-off value for predicting preeclampsia; the sensitivity, specificity, PPV, and NPV were 66.7%, 71.5%, 17.2%, and 96.2%, respectively. When a combination of abnormal serum HIF-1α levels and abnormal uterine artery Doppler PI (above the 95th percentile) were used as a predictive value to predict preeclampsia, the sensitivity, specificity, PPV, and NPV were 74.2%, 67.2%, 16.6%, and 96.8%, respectively. This study showed that the serum HIF-1α levels with or without uterine artery Doppler at 11–13+6 weeks of gestation were effective in predicting preeclampsia.

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EP08.13: Performance of first trimester uterine artery Doppler in the prediction of pre-eclampsia

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.15597 ◽

2015 ◽

Vol 46 ◽

pp. 212-212

Author(s):

G.R. Lobo ◽

P.M. Nowak ◽

L. Nardozza ◽

D.S. Pares

Keyword(s):

Uterine Artery ◽

First Trimester ◽

Uterine Artery Doppler

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First trimester uterine artery Doppler and subsequent intrauterine growth restriction and preterm birth

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2004.09.085 ◽

2004 ◽

Vol 191 (6) ◽

pp. S22

Author(s):

Lorraine Dugoff ◽

John Hobbins ◽

Vincent Faber ◽

Fergal Malone ◽

Michael Belfort ◽

...

Keyword(s):

Preterm Birth ◽

Intrauterine Growth Restriction ◽

Uterine Artery ◽

First Trimester ◽

Growth Restriction ◽

Uterine Artery Doppler ◽

Intrauterine Growth

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Effect of serum from women with abnormal uterine artery Doppler resistance on extravillous trophoblast invasion in the first trimester

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2005.10.659 ◽

2005 ◽

Vol 193 (6) ◽

pp. S165

Author(s):

Ramesh Ganapathy ◽

Laura Ayling ◽

Guy Whitley ◽

Judith Cartwright ◽

Basky Thilaganathan

Keyword(s):

Uterine Artery ◽

First Trimester ◽

Extravillous Trophoblast ◽

Trophoblast Invasion ◽

Uterine Artery Doppler

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First-trimester uterine artery Doppler velocimetry in the prediction of birth weight in a low-risk population

Prenatal Diagnosis ◽

10.1002/pd.3997 ◽

2012 ◽

Vol 33 (1) ◽

pp. 21-24 ◽

Cited By ~ 4

Author(s):

Andres Sarmiento ◽

Alexandra Casasbuenas ◽

Nadiezhda Rodriguez ◽

Ana M. Angarita ◽

Piedad Sarmiento ◽

...

Keyword(s):

Birth Weight ◽

Uterine Artery ◽

First Trimester ◽

Low Risk ◽

Doppler Velocimetry ◽

Risk Population ◽

Uterine Artery Doppler

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Significance of obstetric Doppler studies in prediction of perinatal outcome in pregnancy induced hypertension

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172312 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2354 ◽

Cited By ~ 1

Author(s):

Pradip R. Gaikwad ◽

Manisha R. Gandhewar ◽

Nity Rose ◽

Vidyadhar Suryakar

Keyword(s):

Diagnostic Accuracy ◽

Doppler Ultrasound ◽

Predictive Value ◽

Perinatal Outcome ◽

Uterine Artery ◽

Pregnancy Induced Hypertension ◽

Doppler Studies ◽

Uterine Artery Doppler ◽

Adverse Perinatal Outcome ◽

Induced Hypertension

Background: Pregnancy induced hypertension (PIH) is associated with adverse perinatal outcome. Multi vessel color Doppler studies are useful in these cases for timely intervention. The aim of present study was to know the significance of umbilical, middle cerebral and uterine artery Doppler studies in PIH and to analyse its role in predicting perinatal outcome.Methods: This was a prospective study of 106 singleton pregnancies in the third trimester with PIH. The results of last Doppler ultrasound within one week of delivery were used for analysis. Adverse perinatal outcome was studied in the form of emergency cesarean section for fetal distress, meconium stained amniotic fluid, Apgar at 5 min <7, NICU admission and perinatal mortality (stillbirths and neonatal death). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of various Doppler parameters were calculated after comparing with standard.Results: In the present study specificity and diagnostic accuracy of all Doppler ultrasound parameters was high in predicting adverse perinatal outcome. Cerebroplacental ratio showed highest specificity (98.55%), PPV (94.44%) and diagnostic accuracy (80.19%) in predicting adverse perinatal outcome and it is better than MCA PI and UA PI alone. Uterine artery Doppler evaluation also gives additional information in predicting adverse perinatal outcome.Conclusions: Amongst various Doppler parameters cerebroplacental index (MCA/UA PI) is best predictor of adverse perinatal outcome.

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