Role of the First Trimester Maternal Serum High Sensitivity C-Reactive Protein and Second Trimester Placental Volume Measurement by 3d Doppler Ultrasound in Early Detection of Preeclampsia

Abstract

Background: Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure and a significant amount of protein in the urine. It affects 2–8% of pregnancies worldwide. Complications include impaired liver function, kidney dysfunction, visual disturbances and red blood cell Breakdown. PE continues to be a major cause of maternal and fetal mortality. Thus, efforts at discovering reliable prediction models to identify those at risk at an early stage are critical. And since Placental maldevelopment plays a pivotal role in the pathogenesis of PE, therefore, evaluation of the placental volume and vascular flow indices using different techniques can contribute in the prediction of adverse pregnancy outcomes. Aim of the Work: to assess the ability of high sensitivity c reactive protein (Hs CRP) and 3D power Doppler of placental volume and vascular flow indices to predict Preeclampsia. Patients and methods: This is a prospective cohort study by multi operators conducted on 200 women with singleton pregnancy who underwent screening for eligibility and eventually included with respect to the inclusion criteria. The study has been done during the period from October 2015 till December 2016. 1st trimesteric serum level of HsCRP detection tests, 1st trimesteric abdominal ultrasonographic examination and 2nd trimesteric color-Doppler techniques were done and placental volume was measured and Follow up at delivery to confirm Pre-eclampsia has followed. Study Outcomes included the development of hypertention, limb edema or other of pre-eclampsia complication. Data were statistically analyzed using IBM© SPSS© Statistics version 23. Results: HsCRP was significantly (P≤ 0.05 and 0.01) high in Pre-eclampsia group compared to the normal pregnancy group. Moreover, Placental volume (PV), Vascularization index (VI), Flow index (FI) and Vascularization flow index (VFI) were significantly (P≤ 0.05 and 0.01) lower in Pre-eclampsia group than the normal pregnancy group.Conclusion: there was a statistically significant correlation between first-trimester HsCRP and the 2nd trimester placental volume and its vascular indices in the prediction of complications of uteroplacental insufficiency. Further studies with large number of patients have to be carried out to reach conclusive evidence of the significance Doppler in prediction of pre-eclampsi, .and HsCRP.