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Is it Possible to Predict Preeclampsia Early by Maternal Pregnancy Associated Plasma Protein-A and Uterine Artery Doppler? A Randomized-Controlled Trial

Background: Hypertensive disorders in pregnancy, along with IUGR and low birth weight, are among the major causes of maternal mortality and morbidity. It is one of the most common pregnancy complications. Its incidence ranges between 10-12% of all pregnancies. Early detection of preeclampsia (PE) is of utmost importance to start early intervention that prevents maternal and fetal comorbidities and decreases maternal and fetal mortality. Objectives: To predict the role of maternal serum pregnancy-associated plasma protein-A (PAPP-A) and uterine artery Doppler in females between 11-14 weeks of gestation for early detection of preeclampsia. Patients and methods: This randomized-controlled trial was done at Benha Teaching Hospital Department of Obstetrics & Gynecology over 200 pregnant women with gestational ages of 11-14 weeks. Blood pressure was recorded, uterine artery Doppler was done, and a blood sample for PAPP-A was drawn. Results: Uterine artery pulsatility index (PI) at 11-14 weeks of gestation is a good screening method for preeclampsia. The mean pulsatility index was more valid than PAPP-A. However, the combination of both in addition to patient history and blood pressure examination is more predictive. Conclusion: Our study concluded that at 11-14 weeks of gestation, uterine artery Doppler and serum level of maternal PAPPA-A were good screening methods for early prediction of preeclampsia.