Assessment of the Role of Maternal Angiogenic Factors and Nitric Oxide in Prediction of Preeclampsia

Document Type : Original Article

Authors

1 Department of Medical Biochemistry , Faculty of Medicine, Cairo University

2 Department of Obstetrics & Gynecology , Faculty of Medicine, Cairo University

3 Department of Public Health & Community Medicine , Faculty of Medicine, Cairo University

Abstract

Preeclampsia has been proposed to be an antiangiogenic state that may be detected by the determination of the concentrations of the soluble vascular endothelial growth factor receptor- 1 (sVEGFR-1) and placental growth factor (PlGF) in maternal blood even before the clinical development of the disease. Aim: The aim of the present study was to determine the role of the combined use of uterine artery Doppler velocimetry (UADV) and maternal plasma PlGF , sVEGFR-1 and NO products concentrations for the prediction of preeclampsia in high-risk women.and to compare these parameters between patients with mild and severe preeclampsia. Subjects and Methods: A prospective cohort study was conducted on 142 women, only 112 were enrolled in the study, patients with preeclampsia were subclassified as either severe or mild preeclampsia. Blood samples were obtained between 22 and 26 weeks of gestation. Doppler ultrasound of the uterine arteries at the time of blood sampling was done. The presence of an early diastolic notch in the uterine arteries was determined. An abnormal UADV was defined as the presence of bilateral uterine artery notches and/or a mean pulsatility index above 95th percentile for the gestational age. Maternal serum PlGF and sVEGFR-1 concentrations were determined with the use of sensitive and specific immunoassays. Nitric Oxide Colorimetric Assay was used also to measure NO products in the maternal blood. Results: Among patients with abnormal UADV, maternal plasma sVEGFR1, PlGF and NO products concentrations contributed significantly in the identification of patients destined to develop mild preeclampsia and severe preeclampsia sVEGFR1 (>2005 pg/ml) and NO products (<50.90 umol/L) were found to be the best predictors for preeclampsia with high sensitivity and specificity followed by PLGF (<286.32 pg/ml). In severe preeclampsia sVEGFR1 (>2900 pg/ml) was the best followed by NO products (<54 umol/L) and PLGF (<234.56 pg/ml). Conclusion: The results of current study suggested that the identification of high concentrations of sVEGFR1 combined with low concentrations of PlGF and NO products, could be used to predict the development of preeclampsia.

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