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Plasma endothelin‐1 and mean arterial pressure in the prediction of pre‐eclampsia
Author(s) -
Shaarawy M,
AbdelMagid A.M.A
Publication year - 2000
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(99)00180-0
Subject(s) - medicine , eclampsia , gestation , endothelin 1 , blood pressure , radioimmunoassay , preeclampsia , mean arterial pressure , obstetrics , predictive value , body mass index , pregnancy , endothelin receptor , first trimester , heart rate , genetics , receptor , biology
Objective : To determine whether increased first trimester plasma endothelin‐1 and/or increased midtrimester mean arterial blood pressure detected in pregnant women who are free of symptoms can predict the subsequent development of pre‐eclampsia. Method : Eighty pregnant women were successfully followed from 10 weeks gestation until delivery. Pre‐eclampsia and eclampsia developed in 29 and 2 women, respectively, whereas 49 women remained normotensive. Plasma endothelin‐1 was determined in the first trimester (10–12 weeks gestation) by a competitive radioimmunoassay. Result : First trimester plasma endothelin‐1 levels in pregnant women who subsequently developed mild, severe pre‐eclampsia and eclampsia were significantly higher than those of pregnant women who remained normotensive. The release of endothelin‐1 increases with the severity of the disease, age, body mass index and mean arterial blood pressure. The predictive values of plasma endothelin‐1 for pre‐eclampsia were: sensitivity 96.8%, specificity 51%, positive predictive value 55.5% and negative predictive value 91%, whereas those of MAP were 48.4, 45, 35.7 and 58%, respectively. Conclusion : Determination of first trimester plasma endothelin level may be a valuable marker to identify 55.5% of individuals at high risk of developing pre‐eclampsia, if combined with midtrimester MAP, the positive predictive value increases to 68.2%.