Z Geburtshilfe Neonatol 2013; 217 - V10_6
DOI: 10.1055/s-0033-1361252

Preliminary results of the MORE PrePARd Study (Microparticle Orientated Risk Evaluation in the Prediction of Preeclampsia Among Risk graviDas): a multicenter prospective prognostic marker study

JS Fitzgerald 1, T Groten 2, C Göhner 1, I Sargent 3, M Sossdorf 4, W Lösche 4, UR Markert 1, E Schleußner 2
  • 1Universitätsfrauenklinik Jena, Geburtshilfe, Placenta-Labor, Jena, Germany
  • 2Universitätsfrauenklinik Jena, Geburtshilfe, Jena, Germany
  • 3Nuffield Department of Obstetrics and Gynaecology, Oxford, United Kingdom
  • 4Friedrich Schiller Universität Jena, Klinik für Anästhesiologie und Intensivtherapie, Jena, Germany

Background: Preeclampsia (PE) is a potentially dangerous pregnancy pathology contributing to higher worldwide mortality and morbidity. The negative influence of syncytiotrophoblastic microparticles (STBMs) on the placenta and maternal endothelia is thought to play a key role in generating the inflammatory effects that lead to PE symptoms. Doppler sonography of the uterine arteries assists in identifying a risk population but is featured by a low positive predictive value.

Aim: Aim of this study is to evaluate whether STBMs can serve as an accessory marker to conventional Doppler sonography to better identify pregnant women who will actually develop PE.

Methods: Pregnant women between 19 – 21 gestational weeks (GW) with abnormal uterine perfusion were enrolled into this prospective study. Plasma samples were taken at inclusion and at two further visits at 8 week intervals to follow STBM concentration. The primary endpoint assessed is PE and/or HELLP syndrome. Other PE-associated pathologies (IUGR, IUFD, placental abruption, premature delivery) constitute the secondary endpoints. Maternal STBM concentrations were measured using a homemade Enzyme Linked Sorbent Assay specifically measuring STBMs. The receiver operating characteristics (ROC) for baseline measures are graphically displayed and area under curve (AUC) is estimated including 95% confidence levels.

Results: Of the 73 included women, 16 developed PE (cases) and 56 did not (control). After analyses of mid-gestational probes, the ROC curve was in close proximity to the line of no-discrimination.

Discussion: Our preliminary results indicate that the maternal STBM concentration at mid-gestation does not predict the development of PE or associated pregnancy pathologies. Further analysis is underway to assess whether STBM measurements at later gestational time points can predict PE shortly before onset of disease. The method used here might not be sensitive enough to measure maternal STBM concentrations at mid-gestation.