Analysis of the relationship between maternal second trimester afp, hcg, estriol levels and abnormal uterine artery Doppler findings in the prediction of pregnancy induced

Giriş

The aim of this study was to evaluate the relationship between triple test markers, uterine artery Doppler findings and pregnancy induced hypertension (PIH).

Yöntem

Maternal serum alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and estriol (E3) were evaluated in the screening program for Down syndrome in 829 pregnant women. Uterine artery Doppler studies were performed at 20-26. weeks of gestation. The mean uterine artery resistance index and the presence or absence of early diastolic notches was recorded. Diastolic blood pressure >90 mmHg after the 20th week of gestation in a previous normotensive women was defined as PIH.

Bulgular

PIH developed in 71 women (8.6%). Maternal AFP (1.05 vs. 0.94 MoM, p=0.03) and HCG (1.32 vs. 1.15 MoM, p= 0.036) levels were significantly higher in the PIH group. Mean levels of PI, RI and the prevalence of bilateral notches were significantly higher in cases with PIH. In 212 (25%) of the cases bilateral early diastolic notching (BLN+) was present. Mean AFP level in cases with bilateral notches was significantly higher than in cases with absent or unilateral notches (1.03 vs. 0.92 and 0.93 MoM, p=0.005). Maternal serum level of AFP (AUC 0.63, p=0.0055) was effective in the prediction of PIH in cases with BLN+. Serum level of HCG (AUC 0.54, p=0.45) and E3 (AUC 0.5, p=0.97) were not effective. Using a cut off value of > 0.98 MoM, we could detect cases with PIH with a sensitivity of 65% and specificity 63%.

Sonuç

High maternal AFP, HCG levels, and abnormal uterine artery Doppler findings at second trimester are related with PIH. Maternal AFP level is higher in cases with bilateral notches. In cases with bilateral notches, high levels of maternal serum AFP may be additive for the prediction of PIH. 

Anahtar Kelimeler

Uterine artery Doppler, pregnancy-induced hypertension

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