PP055. Preliminary results of the more prepared study (microparticle orientated risk evaluation in the prediction of preeclampsia among risk gravidas): A multicenter prospective prognostic marker study

J S Fitzgerald; C Göhner; U Markert; T Groten; M Sossdorf; W Lösche; E Schleußner

doi:10.1016/j.preghy.2012.04.166

PP055. Preliminary results of the more prepared study (microparticle orientated risk evaluation in the prediction of preeclampsia among risk gravidas): A multicenter prospective prognostic marker study

Pregnancy Hypertens. 2012 Jul;2(3):271-2. doi: 10.1016/j.preghy.2012.04.166. Epub 2012 Jun 13.

Authors

J S Fitzgerald¹, C Göhner¹, U Markert¹, T Groten², M Sossdorf³, W Lösche³, E Schleußner²

Affiliations

¹ Placenta-Lab/Obstetrics Department, Jena, Germany.
² Obstetrics Department, Jena, Germany.
³ Center for Sepsis Control and Care, University Hospital Jena, Jena, Germany.

PMID: 26105378
DOI: 10.1016/j.preghy.2012.04.166

Abstract

Introduction: Preeclampsia (PE) is a potentially dangerous pregnancy pathology contributing to a higher worldwide mortality and morbidity. The negative influence of syncytiotrophoblastic microparticles (STBMs) on the placenta and maternal endothelia is thought to play a key role in generating the inflammatory effects that lead to PE symptoms. Doppler sonography of the uterine arteries assists in identifying a risk population, however, the positive predictive value for this method is low.

Objectives: Aim of this study is to evaluate whether STBMs can serve as an accessory marker to conventional Doppler sonography to better identify pregnant women who will actually develop PE.

Methods: Pregnant women between 19-21 gestational weeks (GW) with abnormal uterine perfusion were enrolled into this prospective study. Plasma samples were taken at inclusion (baseline) and at two further visits at 8 week intervals to follow STBM concentration alterations during pregnancy. The primary endpoint assessed is PE and/or hemolysis, elevated liver, low platelets (HELLP) syndrome. Other PE-associated pathologies (intrauterine growth retardation [IUGR], intrauterine fetal demise [IUFD], placental abruption, premature delivery) constitute the secondary endpoints. Maternal STBM concentrations were measured using a home made Enzyme Linked Sorbent Assay (ELSA) which specifically measures STBMs. The receiver operating characteristics (ROC) for baseline measures are graphically displayed and area under curve (AUC) is estimated including 95% confidence levels.

Results: Of the 73 women included in the study, 16 developed PE (cases) and 56 did not (control). After analyses of mid-gestational probes, the ROC curve was in close proximity to the line of no-discrimination.

Conclusion: Our preliminary results indicate that the maternal STBM concentration at mid-gestation does not predict the development of PE or associated pregnancy pathologies. Further analysis is underway to assess whether STBM measurements at later gestational time points can predict PE shortly before onset of disease.