Диагностика преэклампсии на основании показателей скрининга I триместра и компонентов состава тела

Abstract

BACKGROUND: According to a large amount of clinical and experimental material, of international protocols of treatment and management of patients, of screening tests, the prevalence of preeclampsia shows no tendency to decline. Absence of possibilities to act on the processes leading to PE, as well as ineffective measures of prevention of this pathology, determine the need for implementation of research for early identification of groups of risk and prevention of PE. AIM: To identify possible markers of development of preeclampsia based on the parameters of the first trimester screening and body composition components in pregnant women without obesity up to 15 weeks of gestation. MATERIALS AND METHODS: A study of 747 women without obesity of 11 to 13 weeks and 6 days of gestation including 30 women with different variants of arterial hypertension and 669 women with physiological pregnancy, was conducted on the base of the Regional Perinatal Center of Yaroslavl. All the women underwent Doppler velocimetry of the uterine arteries, assessment of β-subunit of human chorionic gonadotropin (β-HCG) and pregnancy–associated plasma protein A (PAPP-A) in the blood, examination of the components of body composition and analysis of the maternity case record with history of childbirth. RESULTS: Increase in the pulsation index was identified in Doppler velocimetry of the uterine arteries with sensitivity of 64.7% and specificity of 68.2% in the group with the subsequent development of preeclampsia. PAPP-A was found to have the maximum sensitivity of 45.7% and specificity of 75.5% in identification of the risk group for preeclampsia by blood parameters. No differences in the body composition were found in the study groups. No significant increase in the prognostic capacity of simultaneous analysis of the data of Doppler velocimetry and biochemical examinations and of components of the body composition was found. CONCLUSION: Doppler velocimetry of the uterine arteries is an effective non-invasive screening method for identification of the risk group for development of preeclampsia in pregnant women without obesity.