Identification of patients at risk for early onset and/or severe preeclampsia with the use of uterine artery Doppler velocimetry and placental growth factor
Identification of patients at risk for early onset and/or severe preeclampsia with the use of uterine artery Doppler velocimetry and placental growth factor
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DOI：
10.1016/j.ajog.2006.11.002
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发表时间：
2007-04-01
影响因子：
9.8
通讯作者：
Gonzalez, Rogelio
中科院分区：
文献类型：
--
作者：
Espinoza, Jimmy;Romero, Roberto;Gonzalez, Rogelio
目的：子痫前期被认为是一种抗血管生成状态，甚至在疾病临床发展之前，就可以通过测定母血中可溶性血管内皮生长因子受体-1(sVEGFR-1)和胎盘生长因子(PlGF)的浓度来检测这种状态。本研究的目的是确定联合使用子宫动脉多普勒血流速度计(UADV)和孕中期孕妇血浆PlGF和sVEGFR-1浓度在识别重度和/或早发性子痫前期风险患者中的作用。研究设计：对3348名孕妇进行前瞻性队列研究，以探讨UADV异常与血浆PlGF和sVEGFR-1浓度的关系。在超声检查时采集妊娠22至26周的血浆样本。UADV异常定义为双侧子宫动脉切迹和/或胎龄平均搏动指数高于第95个百分位数。用灵敏和特异的免疫法测定母体血浆中PlGF和sVEGFR-1的浓度。主要结果是早发性先兆子痫(
OBJECTIVE: Preeclampsia has been proposed to be an antiangiogenic state that may be detected by the determination of the concentrations of the soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and placental growth factor ( PlGF) in maternal blood even before the clinical development of the disease. The purpose of this study was to determine the role of the combined use of uterine artery Doppler velocimetry (UADV) and maternal plasma PlGF and sVEGFR-1 concentrations in the second trimester for the identification of patients at risk for severe and/or early onset preeclampsia.STUDY DESIGN: A prospective cohort study was designed to examine the relationship between abnormal UADV and plasma concentrations of PlGF and sVEGFR-1 in 3348 pregnant women. Plasma samples were obtained between 22 and 26 weeks of gestation at the time of ultrasound examination. Abnormal UADV was defined as the presence of bilateral uterine artery notches and/or a mean pulsatility index above the 95th percentile for the gestational age. Maternal plasma PlGF and sVEGFR-1 concentrations were determined with the use of sensitive and specific immunoassays. The primary outcome was the development of early onset preeclampsia (