The study of different biochemical parameters as predictor o
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Among the various causes of maternal morbidity and mortality preeclampsia/eclampsia ranks third along with hemorrhage and sepsis claiming the first two spots of the deadly triad; accounting for 63,000 direct maternal deaths worldwide (13% of all direct causes) with more than 4 million cases per year. Alpha-fetoprotein (AFP) is the most abundant plasma protein found in the human fetus. It is produced by the fetal liver and GI tract. In preeclampsia, there is poor placentation due to trophoblastic dysfunction.

This causes increased leakage of this fetal protein into maternal blood leading to its increased level in the maternal serum. b -hCG and Inhibin-A are secreted from the fetal syncytiotrophoblasts. In preeclampsia, due to the dysfunction of these trophoblastic cells, there is an increased level of these proteins in maternal serum. The aim of this present study is to analyze the potential clinical use of these biochemical (serum b -hCG, Alpha-fetoprotein, Inhibin-A) for the purpose of prediction of preeclampsia.

Pregnant women attending antenatal clinic at 12-14 weeks of gestation. Inclusion criteria: Normotensive patient with singleton pregnancy at 12-14 weeks gestation. Analysis of the results showed- 15 of the total 200 patients developed preeclampsia. Thus incidence was 7.5%. Consistent with previous studies, that stated incidence of 2-8%. Regarding the screening tests, first, the cut-off values for comparison were set by constructing ROC (receiver operating characteristic) curves for each test, and then they were compared for determination of predictive values of each test, as there
is no standardized cut off for these tests. Serum parameters done between 12-16 weeks of pregnancy yielded the following data: MS Alpha-fetoprotein was found raised above the cut-off in 39 subjects; of them, 10 subjects developed preeclampsia.

The sensitivity, specificity, PPV, and NPV of Alpha-fetoprotein for prediction of preeclampsia were 66.67%, 84.32%, 25.64%, and 96.89%. MSb -hCG was found raised above cut off (cut off 2.499 MOM) in 40 subjects; of them, 12 subjects developed preeclampsia. The sensitivity, specificity, PPV, and NPV of b -hCG for prediction of preeclampsia were 80.00%, 84.86%, 30.00%.

Source:https://www.ijogr.org/article-details/12772
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