Serum levels of soluble Endoglin, soluble FMS-like Tyrosine kinase-1, and Uterine Artery Doppler in Pre-eclamptic patients

Background: Pre-eclampsia, a pregnancy-specific disorder, contributes substantially morbidity and mortality of both mother and newborn. An increasing number of biochemical agents were evaluated as markers for predicting pre-eclampsia, much effort has been put into assessing noval potential markers and their combination with other screening methods such as Doppler sonography. The aim of the study was to assess the serum levels of soluble Endoglin (sEng), soluble FMS like tyrosine kinase-1 (sFlt-1), and Uterine Artery Doppler in pre-eclampsia to evaluate their clinical utility in diagnosis, and assessment of severity of the disease. Patients and Methods: The study was conducted on 35 pre-eclamptic patients and 20 healthy pregnant control subjects. All individuals were subjected to clinical examination and estimation of sEng and sFlt-1 by enzyme linked immunosorbent assay and estimation of ALT, Platelet count and urinary proteins, Uterine Artery Doppler measured as pulsatility Index (PI). Results: revealed highly significant increase in sEng and sflt-1, PI and systolic and diastolic blood pressure (SBP and DBP), proteins in urine, and ALT in patients than control(p<0.001), and in severe preeclampsia than in mild preeclampsia (p<0.001),. sEng and sFlt-1 were significantly increased in pre-term pre-eclampsia than in term per-eclampsia and in patients with abnormal Doppler than in normal Doppler(p<0.001). PI was not significantly increased in pre-term than term pre-eclampsia (p>0.05). sEng is positively correlated to sFlt-1(r = 0.94) and both of them are positively correlated to SBP, DBP, PI, urinary proteins, and negatively correlated with gestational age and platelet count. Receiver operating characteristic (ROC) curve analysis was applied to evaluate the diagnostic utility of sEng, sFlt-1, and PI for discriminating the early onset from late onset pre-eclampsia, the best diagnostic cut off levels for sEng and sFlt-1 were >15 ng/ml, >900 pg/ml respectively. Both had a diagnostic sensitivity of 100\%, specificity 78.9\%, accuracy 88.6\%, positive predictive value(PPV) 80\% and negative predictive value(NPV) 100\%, the area under the curve 0.97, 0.99 respectively. While the cut off levels for P1>1.42, had a diagnostic sensitivity of 68\% specificity, 58\%, accuracy 62\%, PPV 58\% and NPV 58\%. Also (ROC) curve analysis was applied to evaluate the diagnostic utility of sEng, sFlt-1, and PI for discriminating the mild from severe pre-eclampsia they had a diagnostic sensitivity 89\%, 83\% specificity 65\%, 70\%, accuracy for both 77\%, PPV, 72\%, 75\% and NPV 84\%, 80\% respectively. As regard PI had a diagnostic sensitivity of 100\%, specificity 94\%, accuracy 97\%, PPV 95\% and NPV 100\%. Conclusion: The results of this study indicate that s Eng, and sFlt-1 are efficient in prediction of early onset pre-eclampsia and can discriminate between severe and mild pre-eclampsia, and both with pulsatility index of Doppler give better prediction of pre-eclampsia. This results will help in finding a new strategy for early management and so reduction of associated complication of pre-eclampsia. {[}Elattar N., Swelam E., El Anwar A. Serum levels of soluble Endoglin, soluble FMS-like Tyrosine kinase-1, and Uterine Artery Doppler in Pre-eclamptic patients. Life Sci J 2012; 9(3): 2106-2113]. (ISSN: 1097-8135). http://www.lifesciencesite.com. 304