Soluble Endoglin as a new marker for prediction of pre-eclampsia in early pregnancy

Objective: To evaluate the use of a new marker in the prediction of pre-eclampsia few months before the onset of manifestations.Materials and methods: Sixty-six women during early pregnancy were enrolled in the present study and were divided as follows: Thirty-three pregnant women: 15 developed gestational hypertension and 18 pregnant women who later developed pre-eclampsia and 33 normotensive pregnant women taken as controls. Exclusion was done to twin pregnancies, cases with fetal abnormalities, maternal renal disease and connective tissue diseases. Serum concentration of angiogenic markers (VEGF, PIGF) and anti-angiogenic marker: soluble Endoglin (sEng) was measured during 14–18weeks gestation using ELISA technique. All women were followed up till delivery.Results: A statistically significant difference was found in comparing the median level of VEGF and PIGF in cases of gestational hypertension and pre-eclampsia with controls (P<0.0005 and P<0.0005). A statistically significant difference was found in comparing the median level of VEGF in gestational hypertension group with pre-eclampsia (P=0.19). The median level of soluble Endoglin had a statistically significant difference in comparing gestational hypertension and pre-eclampsia group with controls (P<0.0005). A cut-off value of 31pg/ml VEGF yielded a sensitivity of 94.4%, specificity of 72.9% with accuracy 78.8%. PIGF at cut-off level of 49pg/ml had a sensitivity of 77.8, specificity of 89.6% with accuracy 86.6%. In case of sEng the sensitivity was 94.4%, specificity was 87.5% and accuracy was 89.5%.Conclusion: Pregnant women who are at risk of developing pre-eclampsia can be offered measuring these markers as a screening method to point out those who are more likely to develop pre-eclampsia and warrant close observation and intervention