Dépistage de la prééclampsie au premier trimestre de la grossesse
OBJECTIVE: To determine the value of combined screening for pregnancy hypertensive disorders by maternal characteristics, first trimester uterine artery Doppler (UAD) and serum biomarkers (Inhibine A, PP-13, hCG, ADAM12, PAPP-A et PlGF). STUDY DESIGN: In this prospective cohort study, 893 nulliparous women had UAD evaluation and collection of serum sample at 11-14 weeks. RESULTS: 40 women developed preeclampsia (4.5%) of which 9 early-onset preeclampsia (1.0%), and 16 severe preeclampsia (1.8%). The best model to predict preeclampsia associated maternal charateristics, PAPP-A and PlGF (detection rate 87.5% for 10% of false positive). UAD was correlated to PAPP-A concentration (r=-0.117 ; p<0.001), and so did not add to predictive accuracy. CONCLUSION: Combination of maternal characteristics and first trimester PlGF and PAPP-A provides a useful screening for severe preeclampsia. First trimester UAD was not an efficient screening tool in this population.
PlGF PAPP-A Preeclampsia Screening Uterine Artery Doppler PlGF PAPP-A