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Background: Hypertensive disorders of pregnancy constitute a major cause of maternal morbidity and mortality. Pre-eclampsia/eclampsia ranks second only to haemorrhage as a specific, direct cause of maternal mortality. A number of markers have been under study for the early detection of this disease. The study aims to evaluate the predictive value of sFlt-1/PlGF ratio for preeclampsia.Methods: This study was conducted in the Department of Gynaecology and Obstetrics of ASCOMS hospital, Jammu for a period of 6 months from Jan 2019 to June 2019. 50 antenatal patients attending the outpatient department with risk factors for developing preeclampsia were enrolled in the study. Their sFlT-1/PIGF ratio was determined at gestational age of 20 weeks to 37 weeks and its predictive value was evaluated.Results: In the present study, 8 patients developed preeclampsia subsequently. The mean sFlt-1/PIGF ratio values were significantly higher in the patients who developed preeclampsia (73.5) than who did not develop the disease (26.07). The positive predictive value at 1 week was 41.66% and negative predictive value was 100%. At 4 weeks, positive predictive value was 66.66% and negative predictive value was 100%.Conclusions: The present study suggests sFlt-1/PIGF ratio values are useful marker was a predictor of preeclampsia and values >38 were associated with preeclampsia. It is more useful in ruling out preeclampsia than ruling in the disease.
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Background: Pregnancy was a critical period. This study aimed to examine the effect of murattal al-Quran therapy on the level of anxiety, sFlt-1, and PIGF level in pregnant women with preeclampsia risk.Methods: A quasi-experimental study was conducted in February, 2018. Ten participants received routine midwifery care were combined with murattal of the Qur'an therapy, the rests as control group. Variables were measured at pre and post 12 interventions. Interviews were conducted after the intervention.Results: There was a mean difference of anxiety of 5.250 (SD of 11.021, 95% CI: 0.092-10,408, p-0.046), sFlt-1 p=0.411, PIGF p=0.002, sFlt-1/PIGF ratio p=0.001.Conclusions: This study found a decrease in the level of anxiety, increase score of PIGF and decrease of sFlt-1/PIGF ratio among pregnant women with the risk of preeclampsia who received routine midwifery care plus al-Quran Murattal therapy.
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To prepare the human placental growth factor 2 (PIGF-2 ),human PIGF-2 gene was cloned into pPIC9K vector to construct the recombinant pPIC9K-PIGF-2 vector. Linearized recombinant pPIC9K-PIGF-2 was transformed into Pichia pastoris by electroporation. YPD-Geneticin plate was used to screen geneticin hyper-resistant colonies. The positive colonies were verified by PCR. Results of SDS-PAGE and Western blot showed that recom-binant human PIGF-2 was expressed after being induced by methanol. Using its characteristic heparin binding, recombinant human PIGF-2 was successfully purified by heparin affinity column chromatography.
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Introduction@#Preeclampsia remains to be a major cause of both fetal and maternal morbidity and mortality, particularly in severe forms leading to preterm birth. There is a lack of consensus, however, on the preferred screening test for early diagnosis with the aim of reducing the prevalence and morbidity of the disease. @*Objective@#To compare the performance of the comprehensive first trimester screening using maternal characteristics, ultrasonographic findings and serum biochemical markers, with the NICE and ACOG guidelines in predicting the development of preeclampsia. The study also aims to determine the compliance rate of clinicians in giving aspirin prophylaxis using the different screening tests. Methodology: This is a retrospective, analytical, cross sectional study of all pregnant patients between 11 to 13 6/7 weeks referred for comprehensive first trimester screening for preeclampsia from January 2014 to January 2018. Maternal factors were assessed to determine the risk of preeclampsia using NICE guidelines, ACOG guidelines and comprehensive first trimester screening. The compliance on aspirin administration for high-risk patients was also determined. The outcome measure was diagnosis of preeclampsia and the detection rate (DR) of the three screening tests were compared. @*Results@#A total of 202 women were included in the analysis where 24 (11.9%), 11 (5.4%) and 13 (6.4%) developed preeclampsia, early-onset preeclampsia (EO-PE) and late-onset preeclampsia (LO-PE) respectively. The NICE and ACOG guidelines were able to detect preeclampsia with an accuracy of 76.73% (Sn 75%, Sp 77% PPV 30.5%) and 43.07% (Sn 83.3%, Sp 37.6% PPV 15.3%) respectively. The comprehensive first trimester screening was able to detect preeclampsia with an accuracy of 89.60% (Sn 83.3%, Sp 90.5% PPV 54.1%). EO-PE and LO-PE were detected with an accuracy of up to 97.2% using the comprehensive screening (Sn 90.9%, Sp 97.9% PPV 71.4%), compared with the NICE guideline (up to 74.26%, Sn 81.8%, Sp 73.8% PPV 15.3%) and the ACOG guideline (up to 39.6%, Sn 90.9%, Sp 36.6, PPV 7.63%). Compliance with the NICE and ACOG recommendation on aspirin administration was only 42.37% and 33.33%, respectively, and this increased to up to 62% when comprehensive first trimester screening was used. @*Conclusion@#This study confirmed that the performance of screening for PE, and therefore appropriate selection of the patients that would benefit from prophylactic use of aspirin and closer surveillance, is by far superior if the comprehensive first trimester screening is used than the method advocated by ACOG and NICE.
Subject(s)
Pre-Eclampsia , Pregnancy-Associated Plasma Protein-AABSTRACT
Objective To determine the PAPPA and PIGF levels in maternal serum at second trimester(15 to19 weeks)to e-valuate the role of these in the prediction of preeclampsia at last trimester.Methods Using premeasure postmeasure design, identified 204 singleton pregnancies within 15 to 19 weeks of gestation that followed 89 who had developed preeclampsia during 36 and 40 weeks,gestation at Weinan Municipal Maternal and Child Health Hospital at June 2013 and July 2015,115 with normotensive pregnant.PAPPA and PIGF concentration were determined.Results ①PAPPA and PIGF levels were significantly reduced in the preeclampsia groups compared to the normotensive pregnant group at second trimester (2.3μg/ml vs 4.6μg/ml,U=11.31,P=0.017;78 pg/ml vs 160 pg/ml,U=8.26,P=0.003).②PAPPA and PIGF levels were sig-nificantly reduced at last trimester compared to second trimester in the preeclampsia groups (1.6μg/ml vs 2.3μg/ml,U=9.41,P=0.011;56 pg/ml vs 78 pg/ml,U=6.77,P=0.023).③Receiver operating characteristic curve analysis showed that at second trimester(at 15 to 19 weeks)a cutoff value of 2.2μg/ml for PAPPA and a cutoff value of 75pg/ml for PIGF were able to predict preeclampsia with specificity,sensitivity and area under the curve (AUC)61.7%,87.8%,AUC 0.86(95%CI,0.83~0.91)respectively.Conclusion Measuring PAPPA and PIGF in the second trimester(at 15 to 19 weeks)may be useful in the prediction of preeclampsia.
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OBJECTIVE: The goal of this study was to compare serum concentrations of VEGF, placental growth facto r(PlGF), soluble VEGF receptor-1 (sVEGFR-1) and the expression of VEGF-A in placental tissue from preeclamptic pregnancy with normal pregnancy. METHODS: From pregnant women with (n=46) and without (n=40) preeclampsia, maternal serum in third trimester and placental tissue at delivery were collected. The serum concentrations of VEGF, PlGF, and sVEGFR-1 were measured. The expression levels of VEGF-A protein in placenta were assessed using Western blot. RESULTS: The concentrations of total VEGF, PlGF were significantly decreased and that of sVEGFR-1 was significantly increased in patients with preeclampsia. The expression of VEGF-A protein was lower in preeclamptic placenta than in control placenta, but there was no significant difference. CONCLUSION: The abnormality of angiogenic factors (VEGF, PlGF, sVEGFR-1) may be important in the development of pathophysiology of preeclampsia. An elevation of sVEGFR-1 may lead to suppression of VEGF and PlGF effects, and also the down-regulation of VEGF-A protein in placenta may result in the decreased maternal vascular adaptation to pregnancy.