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Objective To investigate the clinical value of serum activin A,endoglin combined with uterine artery pulsatility index in predicting preeclampsia.Methods One hundred cases pregnant women who were admitted to the obstetrics clinic of Longhua New District People′s Hospital in Shenzhen from December 2016 to July 2017 were selected ,50 cases of preeclampsia were in the observation group,and another 50 cases of healthy pregnant women were in the control group.Serum activin A,endoglin and uterine artery pulsatility index ( UAPI ) were measured at 11 ～ 13 weeks respectively.Receiver operating characteristic curve was used to analyze the diagnostic value of activin A,endoglin and UAPI in different gestational weeks separately and jointly in predicting preeclampsia.Results At 11～13 weeks of pregnancy, the serum activin A((379.98±153.80)ng／L],endoglin((9.87 g±1.62)μg／L) and UAPI (0.97±0.09) in the observation group were significantly higher than in the control group ((205.45±93.29)ng／L,(6.61 ±1.54)μg／L, ( 0.82 ± 0.15 )), and the difference was statistically significant ( all P＜ 0.05 ).The multivariate Logistic regression analysis showed that serum activin A, endoglin level and UAPI in early pregnancy were the risk factors for preeclampsia ( all P＜0.05).ROC curve analysis showed that the joint prediction of activin A, endoglin and UAPI in different gestational weeks was better than that in single detection.The maximum area (AUC) of the joint prediction of activin A,endoglin and UAPI at pregnant 11～13 weeks was 0.969, the sensitivity was 82.0%, and the specificity was 100.0%.Conclusion The combined detection of serum activin A, endothelial factor and uterine artery pulsation index in early pregnancy can be used to predict preeclampsia with high sensitivity and specificity,and can be used as a clinical index to predict preeclampsia.
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Introduction@#Preeclampsia, which affects about 2-8% of pregnancies, is major cause of maternal and perinatal morbidity and mortality, particularly in developing countries. In Mongolia, preeclampsia and eclampsia occurred among pregnancy complications about 25% in recent years. There is a percentage for a cause of maternal death was 17.7% in preeclampsia and eclampsia between 2012 and 2015 in Mongolia.</br> Effective prediction of preeclampsia can be achieved at 11-13 week’s gestation by combination of maternal characteristics, mean arterial pressure (MAP), uterine artery pulsatility index (UtA PI), maternal serum placental growth factor (PlGF), and pregnancy-associated plasma protein-A (PAPP-A).@*Goal@#To investigate plasma concentration of PIGF and PAPP-A, in pregnant women at 11-13+6 of gestation for screening of preeclampsia, To examine the performance of first-trimester screening for preeclampsia based on maternal characteristics, MAP, and mUt.A-PI.@*Materials and Methods @#The study conducted among 393 single pregnant women at 11-13+6 weeks, who were visiting antenatal care services, between March, 2015 and June, 2017. The prospective Cohort research method was used for this study. Written informed consent was obtained from all participants. Maternal plasma PAPP-A, PlGF were determined using Perkin Elmer kits by fluoroimmunoassay.</br> Measurement of MAP was by validated automated devices (HEM-7120, Оmron, Japan). MAP was calculated from the formula DP + 1/3*(SP-DP), where DP represents diastolic blood pressure and SP- systolic blood pressure. Trans-abdominal ultrasound (Voluson E8, GE, USA) examination was carried out for Ut.A-PI.@*Results@#In the study population, there were 66 (16.8%) cases that experienced preeclampsia and 327 (83.2%) cases that were unaffected by preeclampsia. The result showed that the mean concentration of PlGF was 38.6±19.6 pg/ml in PE group whereas the mean was 45.1±24.0 pg/ml in normal pregnant women. Level of PAPP-A was 366.1±195.3 mU/L in group with PE, 633.6±496.9 mU/L in group without preeclampsia. </br> The best Youden’s index and area under the curve (AUC) for MAP and mUt.A-PI were as a predictor of PE. It can be shown that the cutoff point for MAP was 89.5 mmHg (sensitivity-71.2%; specificity-75.5% J-0.467; AUC-0.792; P<0.001). The cutoff point of mUt.A-PI was 2.34 (sensitivity-33.3%; specificity-77.7% J-0.12; AUC-0.577; P<0.001).@*Conclusions@#The concentration of PIGF and PAPP-A in pregnant women with preeclampsia at 11-13+6 of gestation was lower than normal pregnant women. The detection risk of PE by MAP is more accurate than the mUtA-PI measurement.
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Objective:In vitro fertilization and embryo transplantation in patients with endometrial implantation window phase of natural killer cell ( uNK ) influence on the endometrial microvascular and uterine artery pulsatility index and embryo implantation.Methods:A retrospective analysis of our hospital from January 2009 to July 2013 the implementation of in vitro fertilization and embryo transfer(IVF-ET) clinical data of 37 patients,according to whether the success of pregnancy and at least 2 times for IVF-ET failure into success group(26 cases)and the failure group(11 cases),compared two groups of research object during the window of implantation in the uterus endometrial uNK cell marker CD56+, uterine artery pulsatility index, vascular endothelial marker F8 factor,alpha smooth muscle actin( alpha SMA) and myosin heavy chain( SMM) and the relationship between the expression of difference.Results:Success group based FSH 3.52±0.68(mU/ml),basal antral follicles of 9.44±2.53 compared with the failure group differences were not statistically significant(P>0.05).The successful group of uNK cells of 27.18±5.94(%),MVD 6.79±1.74 (%) ,αSMA 33.72 ±4.19 (%) , SMM 25.19 ±5.83 (%) were significantly higher than the expression rate of IVF-ET assisted reproductive failure group(P0.05).Conclusion:During the window of implantation in the endometrium of natural killer cells and endometrial angiogenesis was significantly associated with successful pregnancy, may have a certain relationship;uterine artery PI and pregnancy outcome successful has no obviously relationshhip.