RESULTS
The demographic attributes of the patients that took part in the study are all presented in Table 1.
Examining the average maternal blood ischemia modified albumin level in pregnant diagnosed with preeclampsia and healthy pregnant included in the study, there is a statistically significant difference was determined between both groups (p<0,001).
The distribution of the relation between IMA and S/D rates got because of the artery Doppler measurements is seen in Table 2. The relation between umbilical artery S/D rates and IMA was separately examined in the preeclamptic pregnant and control group. Statistically significant differences were determined (p<0,001).
It is seen that the brain sparing effect got with the rating of umbilical artery pulsatility index and middle cerebral artery pulsatility index has a correlation with the IMA in the study’s population (p<0,001). The correlation between brain sparing effect and IMA level was separately analyzed in the preeclampsia group and control group. Statistically significant difference was determined in both groups (p<0,001) and it is shown in Table 2.
The correlation between non stress test and IMA was investigated in the entire patient group. Statistically significant differences were determined (p<0,001). The correlation between NST and IMA was separately analyzed in preeclampsia and control groups. The average IMA level in preeclampsia patients was 10,69 IU/ml ±1,92 in the presence of normal NST while the average IMA level was 20,72 IU/ml ±1,15 in the presence of abnormal NST and statistically significant differences were determined among them (p<0,001) (Table 2).
The correlation between 5th minute APGAR score and IMA level was showed. The average IMA level was 8,24 IU/ml ±1,64 in patients whose APGAR score was 6 or more, it was 14,15 IU/ml ±1,54 in patients whose APGAR score was less than 6. Statistically significant differences were determined (p<0,001). The correlation between APGAR score and IMA was separately evaluated in preeclamptic pregnant and control group patients (p<0,001). The IMA level was 6,28 IU/ml ±1,57 when the 5th minute APGAR score was determined as 6 or higher in the control group while it was é than 7,15. A statistically significant difference was determined between IMA level and pH (p<0,001). The correlation between IMA level and pH value of cord blood was studied in preeclampsia and control groups. The average IMA level was 10,17 IU/ml ±1,64 when the pH value in preeclampsia group was determined to be higher than 7,15 while it was 22,48 IU/ml ±1,86 when the pH value was determined to be equal or lower than 7,15 (p<0,001). For the control patients, the IMA level was 7,28 IU/ml ±1,57 when the pH value was higher than 7,15 and IMA level was 19,09 IU/ml ±0,125 when it was committed to be equal or lower than 7,15 (p<0,001).
In the ROC curve drawn in terms of the role of IMA in predicting fetal hypoxia (Figure 1), the part below the curve was significantly high (AUC=0,880; p<0,001), for this reason it was evaluated as a high diagnostic value. When the cut-off value is taken 18 IU/ml, sensitivity was 85,3%, specificity was 91% while positive predictive value was 70% and negative predictive value was 96%.