Soluble endoglin and uterine artery Doppler ultrasonography as markers
of progression to preeclampsia in women with gestational hypertension:
nested case-control study.
Abstract
Objective: To determine the clinical usefulness of the soluble endoglin
(sEng) and uterine artery Doppler ultrasonography as markers of
progression to preeclampsia in women with gestational hypertension (GH).
Design: Nested case-control study. Setting: Mexico City, Mexico.
Population or sample: 77 singleton pregnant women with GH. Methods:
Cases were women who progress to preeclampsia (n=36) and controls were
those who did not (n=41). Serum sEng concentrations and uterine artery
Doppler ultrasonography were performed at enrollment. Main outcome
measures: Progression to preeclampsia and occurrence of adverse
outcomes, such as preterm delivery (PD) <37 and <34
weeks of gestation, small-for-gestational-age (SGA) infant, and fetal
growth restriction (FGR). Results: Women with sEng values in the highest
tertile had higher risk of progression to preeclampsia, PD<34
weeks of gestation, and FGR, odds ratios (ORs) ≥ 3.7. Patients with
abnormal uterine artery Doppler pulsatility index (>95th
percentile) had higher risk of progression to preeclampsia, PD
<34 weeks of gestation, SGA infant, and FGR (ORs ≥ 3.3). The
presence of notch was associated with higher risk of progression to
preeclampsia, PD <37 and <34 weeks of gestation, SGA
infant, and FGR (ORs ≥ 2.9). However, logistic regression analysis
revealed that only serum sEng was a significant and independent risk
factor for progression of GH to preeclampsia, PD <34 weeks of
gestation, and FGR (ORs ≥3.1). Conclusions: sEng is a reliable biomarker
of progression to preeclampsia, PD and FGR in patients with GH. Compared
to sEng, uterine artery Doppler ultrasound has limited clinical
usefulness as marker.