PREDICTIVE VALUE OF BIOMARKERS, CLINICAL AND INSTRUMENTAL PARAMETERS FOR EARLY-ONSET PREECLAMPSIA IN MULTIPLE PREGNANCY

The aim is to evaluate the prognostic significance of biomarkers and clinical and instrumental parameters in the first trimester of pregnancy for the prediction of early preeclampsia in multiple pregnancy. The authors analyze a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5), placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), beta-human chorionic gonadotropin (β-hCG), pregnancy associated plasma protein-A levels, arterial pressure, and Doppler parameters of the uterine arteries. The paper reveals that the development of early preeclampsia in multiple pregnancy is associated with a decrease in ADAMTS-5 and PlGF concentrations and an increase in the sFlt-1/PlGF ratio in the first trimester. At the same time, the arterial pressure, β-hCG, PAPP-A, and sFlt-1 levels did not have statistically significant differences compared to the group of patients with uncomplicated multiple pregnancy. The pulsatility index of the uterine arteries was decreased during early-onset preeclampsia development. Combined assessment of arterial pressure, uterine artery pulsatility index, β-hCG, PAPP-A, PlGF and ADAMTS-5 demonstrate significant prognostic value for early-onset preeclampsia in multiple pregnancy. The results confirm the feasibility of using a multimodal model including clinical, biochemical and Doppler parameters for early prediction of preeclampsia in multiple pregnancy.

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