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Med Sci (Basel). 2018 Jul 20;6(3). pii: E57. doi: 10.3390/medsci6030057.

The Use of Biochemical and Biophysical Markers in Early Screening for Preeclampsia in Mongolia.

Author information

1
National Center for Maternal and Child Health, Khuvisgalchdiin Street, Bayangol District, Ulaanbaatar 16060, Mongolia. ts_urjee@yahoo.com.
2
Department of Biochemistry and Laboratory Medicine, School of Biomedicine, Mongolian National University of Medical Sciences, S.Zorig Street, Sukhbaatar District, Ulaanbaatar 14210, Mongolia. ariunbold@mnums.edu.mn.
3
Department of Biochemistry and Laboratory Medicine, School of Biomedicine, Mongolian National University of Medical Sciences, S.Zorig Street, Sukhbaatar District, Ulaanbaatar 14210, Mongolia. munkhtsetseg.j@mnums.edu.mn.
4
Department of Obstetrics and Gynecology, School of Medicine, Mongolian National University of Medical Sciences, S.Zorig Street, Sukhbaatar District, Ulaanbaatar 14210, Mongolia. t_erkhembaatar@yahoo.com.

Abstract

Preeclampsia (PE) is a major cause of maternal and perinatal morbidity and mortality, particularly in developing countries. In Mongolia, preeclampsia and eclampsia have occurred among pregnancy complications at a rate of 25% in recent years. Recent studies in the literature have screened for preeclampsia by combining maternal factors with biomarkers. This study was conducted using prospective cohort research including 393 singleton pregnancies at 11⁻13+6 weeks. Maternal plasmas pregnancy-associated plasma protein-A (PAPP-A) and maternal serum placental growth factor (PlGF) were measured using Perkin Elmer time-resolved fluoroimmunoassay (DELFIA) kits, and the measurement of mean arterial pressure (MAP) was performed by automated devices and the uterine artery pulsatility index was measured by Doppler ultrasound. In the study population, there were 16.7% showing complicated preeclampsia. The receiver-operating characteristics (ROC) curve analysis showed a sensitivity of 71.21%, and a specificity of 75.54% when the mean arterial pressure cut-off was 89.5 mm; while a sensitivity of 33.36% and specificity of 77.68% were observed when the uterine artery mean pulsatility index (mPI) cut-off was 2.34; a sensitivity of 79.66% and specificity of 44.04% were observed when the PAPP-A cut-off was 529.1 mU/L; and a sensitivity of 74.58% and specificity of 46.6% were observed when the PlGF cut-off was 39.87 pg/mL. The detection rates following the combination of markers with the maternal history were as follows: 62.7% with mean arterial pressure, 69.5⁻82.9% with two markers 86.5% with three markers and 91.4% with four markers. In conclusion, the mean arterial pressure was highly sensitive and demonstrated its easy usage and cost-effectiveness as a predictive marker for the early screening of preeclampsia from other biomarkers.

KEYWORDS:

mean arterial pressure; placental growth factor; preeclampsia; pregnancy-associated plasma protein-A

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