In Bulgaria the first trimester Down syndrome screening was first performed in 2006. For a three years period over 13000 pregnancies have been screened. The aim of the study is to evaluate the role of low PAPP-A levels in prediction of PE and early PE alone, or together with some risk factors. Four hundred and twenty singleton pregnancies that underwent first trimester Down syndrome screening between January 2008 and December 2010 had been analyzed. Fifty patients (11.9%) developed PE, of which 17 required delivery before 34th gw. The control group consists of 279 women who delivered term healthy babies. The borderline for evaluation of the risk of PE is set on 0.4 MoM. Twenty out of 50 (40%) patients with PE, 11 out of 17 (64.7%) patients with early onset PE and 87 out of 279 (31.2%) controls had PAPP‑A levels below this border. These levels were associated with 1.5 RR for PE development. Low first trimester PAPP-A levels alone were associated with a poor prognostic value for development of PE. Together with the maternal age and especially with uterine arteries Doppler a significant prognostic value improvement was found. This combination provides a good possibility for evaluation of the patients at risk for such pregnancy complication.
Key words: PAPP-A, first trimester screening, preeclampsia, Doppler, risk factors
Topic: MEDICINE