Uterine artery Doppler and biochemical markers (PAPP-A, PlGF, sFlt-1, P-selectin, NGAL) at 11+0 to 13+6weeks in the prediction of late (>34weeks) pre-eclampsia

Objective: To determine the performance of screening for late pre-eclampsia (PE) by maternal characteristics, uterine artery Doppler and a set of biochemical markers at 11+0 to 13+6weeks' gestation. Methods: Prospectively enrolled women at 11+0 to 13+6weeks. Maternal characteristics, highest UtA pulsatility index and serum placental biomarkers including pregnancy-associated plasma protein-A, placental growth factor, soluble fms-like tyrosine kinase 1, P-selectin and neutrophil gelatinase-associated lipocalin were recorded. Results: The rate of PE was 2.5% (13/528). Four (0.8%) had severe PE. A combined screening model that included placental growth factor, soluble fms-like tyrosine kinase 1 and neutrophil gelatinase-associated lipocalin could detect 77% of PE at a 10% false-positive rate. Mean risk for mild PE was 8.8% ± 6.4, mean risk for severe PE was 38.6% ± 4.3. Mean risk for controls was 2% ± 4.1. Conclusion: This combination of maternal biochemical variables in the first trimester can detect a consistent number of late PE. Further studies on a new and independent series of data could confirm the presented results. © 2011 John Wiley & Sons, Ltd.