Clinical Study On A Combined Screening Of Pre-eclampsia By Multiple Indicators In The Early Pregnant

Objective To examine the diagnostic accuracy of the model for prediction of preeclampsia(PE)based on maternal characteristics,biophysical and biochemical markers at 11-13+6 weeks' gestation.Retrospective analysis that the correlation between each index of the model and preeclampsia.Methods The doctors collected maternal demographic characteristics and medical history(maternal factors),and measure blood pressure,body mass index and uterine artery pulsatility index at the same time.And the concentrations of serum placenta growth factor,pregnancy associated protein A was detected by Auto DELFIA using Time-resolved fluorescence.The risk of preeclampsia was calculated by the Pre-eclampsia PredictorTM software,and pregnant women who had the high risk of early-onset preeclampsia(Posterior Risk Early more than 1:20)were used low-dose aspirin before 16 weeks of gestation to 28 weeks according to the principle of informed consent.According to pregnancy outcomes,pregnant women were divided into normal control group,gestational hypertension,preeclampsia(divided into early onset PE and late onset PE),chronic hypertension,chronic hypertension with superimposed preeclampsia.The receiver operating characteristic(ROC)curve were applied to evaluate the predictive value of the risk outcomes which by the FMF algorithm combining maternal factors,mean arterial pressure(MAP),uterine artery pulsatility index(UtA-PI),pregnancy associated plasma protein-A(PAPP-A)and placenta growth factor(PLGF).Comparisons between outcome groups were by chi-square test for categorical variables and Mann Whitney-U test for continuous variables.Through using binary logistic regression analysis and calculating the fitting probability of each index,then let the probability value fitting ROC curve analysis,the scheme that each index combination to predict preeclampsia value were evaluated successfully.Results This was a screening study of singleton pregnancies including 19(0.98%)that experienced preeclampsia.Posterior Risk Late predicts late onset preeclampsia with a sensitivity of 61.11%and a specificity of 88.85%.Maternal age,body mass index,in-vitro fertilization and MAP was positively related with preeclampsia and PLGF negatively related with preeclampsia.The area under the ROC curve of the model combined screening by maternal age,body mass index,in-vitro fertilization,placenta growth factor and mean arterial pressure at 11-13+6 weeks' gestation was 0.925,sensitivity was 94.74%,specificity was 79.38%,for all preeclampsia.Conclusion In combined screening by maternal age,body mass index,placenta growth factor,mean arterial pressure provides effective first trimester screening for all preeclampsia.