Publication:

Role of pregnancy associated plasma protein-A and doppler velocimetry in the assessment of fetomaternal outcome in high risk pregnancy

Background The study aimed at defining the role of Pregnancy associated plasma protein-A (PAPP-A) and uterine artery doppler (Ut.A.PI) in the development of adverse pregnancy outcome (APO) in high risk pregnancies.

Methods This was an observational study where 100 singleton pregnancies at high risk of development of APO, between 11 to 13 + 6 weeks POG were enrolled. PAPP-A levels were measured at 11 to 13 + 6 weeks POG and uterine artery doppler PI was measured at 20 weeks. Women were followed till delivery. Pregnancy outcome were seen and a cut off at which APO developed was derived.

Results In this study women with lower mean PAPP-A (0.75±0.19 MOM versus 1.23±0.31MOM) (p 1.42 (>1.19MoM) respectively which was higher than what is determined in other studies done on low risks populations thereby suggesting for an intervention or more meticulous observations at a higher cut offs.

Conclusions PAPP-A and uterine artery doppler are already being used for the screening of preeclampsia in most of the countries but not for other adverse pregnancy outcomes. PAPP-A levels along with the uterine artery PI in predicting APO in high risk women has high negative predictive value. Hence can be uses as a screening method in high risk population whether they should be used for low risk population also needs further evaluation.