Maternal plasma soluble endoglin at 11-13 weeks's gestation in pre-eclampsia

Objectives:
To examine the performance of screening for preeclampsia (PE) by a combination of maternal factors, soluble endoglin (sEng), pregnancy associated plasma protein A (PAPP-A), placental growth factor (PlGF) and uterine artery lowest pulsatibility index (L-PI) at 11-13 weeks of gestation.

Methods:
Uterine artery L-PI, sEng, PAPP-A and PlGF were measured at 11-13 weeks in 90 singleton pregnancies that subsequently developed PE, including 30 that required delivery before 34 weeks (early-PE) and 60 with late-PE, and 180 unaffected controls. Screening performance for PE by maternal factors, sEng, PAPP-A, PlGF and uterine artery L-PI and their combinations was determined.

Results:
In early-PE, compared to controls, plasma sEng and uterine L-PI were significantly increased and serum PAPP-A and PlGF were decreased. In late-PE, compared to controls, serum PlGF was decreased and uterine L-PI was increased but plasma sEng and serum PAPP-A were not significantly different. In screening for early-PE, the detection rate at a 10% false positive rate was 46.7% for sEng alone and 96.3% for a combination of maternal factors, sEng, PlGF and uterine artery L-PI.

Conclusions:
Effective screening for early-PE can be provided by a combination of maternal factors, sEng, PlGF and uterine artery L-PI at 11-13 weeks.