Early Prediction of Preeclampsia in High-Risk Women

Background: The purpose of this study was to determine the role of the combined use of uterine artery Doppler velocimetry (UADV) and maternal serum placental growth factor (PlGF), vascular endothelial growth factor receptor-1 soluble fms-like tyrosine kinase-1 also called soluble (sVEGFR-1), and nitric oxide (NO) products concentrations for the prediction of preeclampsia in high-risk women and to compare these parameters between patients with mild and severe preeclampsia. Methods: Patients at risk of preeclampsia (n = 112) were subclassified as having either severe (n = 38), mild (n = 17), or no preeclampsia (n = 57). Blood samples were obtained between 22 and 26 weeks of gestation. Doppler ultrasound of the uterine arteries was done at the time of blood sampling. Maternal serum PlGF and sVEGFR-1 concentrations were determined with enzyme-linked immunosorbent assay (ELISA). Nitric oxide colorimetric assay was used also to measure NO products in the maternal blood. Results: Among patients with abnormal UADV, maternal serum sVEGFR-1, PlGF, and NO product concentrations contributed significantly in the identification of patients destined to develop mild and severe preeclampsia. sVEGFR-1 (pg/mL) concentration followed by NO product concentration (mu mol/L) were found to be the best predictors for preeclampsia, with high sensitivity and specificity, followed by PlGF (pg/mL). Conclusions: Abnormal UADV and high concentrations of sVEGFR1 combined with low concentrations of PlGF and NO products may be used to predict the development of preeclampsia.