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Screening for pre‐eclampsia by maternal factors and biomarkers at 11–13 weeks' gestation
Ultrasound in obstetrics & gynecology, 2018-08, Vol.52 (2), p.186-195
Tan, M. Y.
Syngelaki, A.
Poon, L. C.
Rolnik, D. L.
O'Gorman, N.
Delgado, J. L.
Akolekar, R.
Konstantinidou, L.
Tsavdaridou, M.
Galeva, S.
Ajdacka, U.
Molina, F. S.
Persico, N.
Jani, J. C.
Plasencia, W.
Greco, E.
Papaioannou, G.
Wright, A.
Wright, D.
Nicolaides, K. H.
2018
Details
Autor(en) / Beteiligte
Tan, M. Y.
Syngelaki, A.
Poon, L. C.
Rolnik, D. L.
O'Gorman, N.
Delgado, J. L.
Akolekar, R.
Konstantinidou, L.
Tsavdaridou, M.
Galeva, S.
Ajdacka, U.
Molina, F. S.
Persico, N.
Jani, J. C.
Plasencia, W.
Greco, E.
Papaioannou, G.
Wright, A.
Wright, D.
Nicolaides, K. H.
Titel
Screening for pre‐eclampsia by maternal factors and biomarkers at 11–13 weeks' gestation
Ist Teil von
Ultrasound in obstetrics & gynecology, 2018-08, Vol.52 (2), p.186-195
Ort / Verlag
Chichester, UK: John Wiley & Sons, Ltd
Erscheinungsjahr
2018
Link zum Volltext
Quelle
Free E-Journal (出版社公開部分のみ)
Beschreibungen/Notizen
ABSTRACT Objective To examine the performance of screening for early, preterm and term pre‐eclampsia (PE) at 11–13 weeks' gestation by maternal factors and combinations of mean arterial pressure (MAP), uterine artery (UtA) pulsatility index (PI), serum placental growth factor (PlGF) and serum pregnancy‐associated plasma protein‐A (PAPP‐A). Methods The data for this study were derived from three previously reported prospective non‐intervention screening studies at 11 + 0 to 13 + 6 weeks' gestation in a combined total of 61 174 singleton pregnancies, including 1770 (2.9%) that developed PE. Bayes' theorem was used to combine the prior distribution of gestational age at delivery with PE, obtained from maternal characteristics, with various combinations of biomarker multiples of the median (MoM) values to derive patient‐specific risks of delivery with PE at < 37 weeks' gestation. The performance of such screening was estimated. Results In pregnancies that developed PE, compared to those without PE, the MoM values of UtA‐PI and MAP were increased and those of PAPP‐A and PlGF were decreased, and the deviation from normal was greater for early than late PE for all four biomarkers. Combined screening by maternal factors, UtA‐PI, MAP and PlGF predicted 90% of early PE, 75% of preterm PE and 41% of term PE, at a screen‐positive rate of 10%; inclusion of PAPP‐A did not improve the performance of screening. The performance of screening depended on the racial origin of the women; on screening by a combination of maternal factors, MAP, UtA‐PI and PlGF and using a risk cut‐off of 1 in 100 for PE at < 37 weeks in Caucasian women, the screen‐positive rate was 10% and detection rates for early, preterm and term PE were 88%, 69% and 40%, respectively. With the same method of screening and risk cut‐off in women of Afro‐Caribbean racial origin, the screen‐positive rate was 34% and detection rates for early, preterm and term PE were 100%, 92% and 75%, respectively. Conclusion Screening by maternal factors and biomarkers at 11–13 weeks' gestation can identify a high proportion of pregnancies that develop early and preterm PE. © 2018 Crown copyright. Ultrasound in Obstetrics & Gynecology © 2018 ISUOG.
Sprache
Englisch
Identifikatoren
ISSN: 0960-7692
eISSN: 1469-0705
DOI: 10.1002/uog.19112
Titel-ID: cdi_proquest_miscellaneous_2054930901
Format
–
Schlagworte
Adult
,
Arterial Pressure - physiology
,
aspirin
,
ASPRE
,
Bayes Theorem
,
Biomarkers - blood
,
Female
,
first‐trimester screening
,
Gestational Age
,
Humans
,
mean arterial pressure
,
Placenta Growth Factor - blood
,
placental growth factor
,
Pre-Eclampsia - diagnosis
,
Pregnancy
,
Pregnancy Trimester, First
,
Pregnancy-Associated Plasma Protein-A - metabolism
,
pregnancy‐associated plasma protein‐A
,
Prospective Studies
,
Pulsatile Flow - physiology
,
pyramid of pregnancy care
,
Risk Assessment - methods
,
SPREE
,
survival model
,
Uterine Artery - physiopathology
,
uterine artery Doppler
,
Vascular Endothelial Growth Factor Receptor-1 - blood
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