Abstract

Preeclampsia is a significant problem worldwide causing both maternal and fetal morbidity and mortality. Many different approaches have been tried to accurately predict the population at risk of developing preeclampsia, so that appropriate screening and preventive interventions can be designed. Placental insufficiency being one of the prime reasons for the development of preeclampsia, markers aimed at detecting abnormalities in placental development and perfusion are prime targets for evaluation. Uterine artery pulsatility index and maternal Placental growth factor levels have shown promising results and are being encouraged to be included in routine screening programmes by many organisations. Aim: This study aims to look at the usefulness of uterine artery pulsatility index and Placental growth factor level to predict preeclampsia development in our population. Methods: This is a hospital based prospective study of 100 women recruited in early pregnancy (11-13 weeks) and had their uterine artery Doppler velocimetry studies and Placental growth factor levels determined. They were followed till delivery and documented various pregnancy and fetal outcomes especially preeclampsia and preterm delivery and small for gestational age babies. Results: In this study, we found that uterine artery pulsatility index (UtPI) was significantly higher and placental growth factor (PlGF) levels were lower early in the pregnancy in women who developed preeclampsia than who remained normotensive. UtPI had a sensitivity, specificity, positive predictive value and negative predictive value of 34.3%, 84.6%, 54.6% and 70.5% respectively. PlGF had a sensitivity, specificity, positive predictive value and negative predictive value of 90%, 23.4%, 15.5% and 93.8% respectively. The mothers of low birth weight babies also had higher uterine artery pulsatility index and lower placental growth factor levels than those who had normal weight babies. Conclusion: UtPI and PlGF are abnormal early on in the pregnancy in women who develop preeclampsia later in the pregnancy. However they have suboptimal sensitivity and more useful for ruling out risk rather than detecting those at higher risk. They by themselves are not reliable and may be more useful as a part of cluster of predictive variables as suggested by NICE guidelines

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