Combined second trimester maternal serum α-fetoprotein and uterine artery Doppler in the prediction of pre-eclampsia

Abstract

Objective The objective was to evaluate the combination of second trimester maternal serum α-fetoprotein (MSAFP) and uterine artery Doppler (UAD) as a tool for the prediction of pre-eclampsia (PE). Background PE is a complex multisystem disease and the main cause of fetomaternal morbidity and mortality. The ultimate aim of antenatal care is to identify women at high risk and provide them with prophylactic treatment. No single test has emerged as a front runner and screening based on risk factors has low sensitivity. This has highlighted the need for an alternative. Patients and methods A prospective study on a total of 297 pregnant women had MSAFP measured between 15 and 19 weeks gestation and UAD measured between 19 and 21 weeks of gestation. Resistance index, pulsatility index (PI), and the presence of notches were measured. Receiver operator characteristic curves were created for MSAFP and UAD alone and in combination and then the outcomes were compared. The study was carried out at the Department of Obstetrics and Gynecology of the Faculty of Medicine, Menoufia University and Nasr City Police Hospital during a period from June 2016 to June 2017. Result A total of 17 women developed PE. The sensitivity of using UAD (resistance index) was 70.59% and for MSAFP was 52.94%. The combined sensitivity of UAD and MSAFP was 64.7% Conclusion The combination of MSAFP with UAD did not improve the screening efficacy for the prediction of PE and UAD performed significantly better as a stand-alone test.