Serum placental growth factor levels and uterine artery pulsatility index at 11-13+6 weeks gestation as early predictors of pre-eclampsia: prospective observational study

Background: To detect serum placental growth factor levels and uterine artery doppler pulsatility index for predicting pre-eclampsia and assess their association with the severity of pre-eclampsia.Methods: A prospective observational study involving 160 antenatal women, from 11-13+6 weeks gestation attending antenatal clinic at tertiary care center during study period of 18 months. Serum placental growth factor levels and uterine artery doppler mean pulsatility index measured and patients were followed upto delivery and observed for the development of pre-eclampsia and its severity.Results: Placental growth factor value cut-off was 40.33pg/ml with the sensitivity of 97.5 % and specificity was 98.3%. For the pulsatility index value of 1.85, the sensitivity was found to be 74.4% and specificity was found to be 92.5%. Mean serum placental growth factor levels for pre-eclampsia patients was 25.09pg/ml and for normotensive patients mean level was 65.05pg/ml. Mean uterine artery doppler pulsatlity index for pre-eclampsia patients was 2.02 and for normotensive patients was 1.39. Mean PI value increased with increasing severity of preeclampsia.Conclusions: Early recognition of women will help initiation of prophylactic measures and enhanced surveillance. First trimester uterine artery doppler with serum placental growth factor together with maternal characteristics can be used as a reliable screening test for preeclampsia prediction and to reduce feto-maternal morbidity.