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Войти в исследования Prenatal diagnosis · 2015
First trimester prediction of HELLP syndrome.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Oliveira Natacha, Poon Liona C, Nicolaides Kypros H, Baschat Ahmet A
Аннотация
OBJECTIVE: The aim of this study was to evaluate first-trimester maternal characteristics and biomarkers in pregnancies that subsequently develop HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome.
METHOD: Maternal history, biochemical, and biophysical parameters were compared between women who developed HELLP, preeclampsia (PE) without HELLP and controls. After determination of significant variables through univariate analysis a first-trimester prediction model was obtained by applying logistic regression analysis. Performance of the model was evaluated.
RESULTS: Twenty participants with HELLP were compared with 147 patients that developed PE without HELLP and 2810 controls. Women with HELLP were more likely Caucasian, nulliparous and presented a higher mean arterial pressure (MAP) when compared with controls. As opposing to women who developed HELLP, women who developed PE without HELLP were more likely of African-American origin and presented an even higher first-trimester MAP. Enrollment biochemical and biophysical parameters were similar between HELLP and PE or controls. Ethnicity, nulliparity, history of previous PE, history of previous HELLP syndrome, and first-trimester MAP were primary risk factors. A prediction rule for HELLP syndrome had an area under the curve of 0.80, with 75% sensitivity for 79% specificity.
CONCLUSION: The majority of pregnancies that develop HELLP syndrome can be predicted in the first trimester. © 2015 John Wiley & Sons, Ltd.
METHOD: Maternal history, biochemical, and biophysical parameters were compared between women who developed HELLP, preeclampsia (PE) without HELLP and controls. After determination of significant variables through univariate analysis a first-trimester prediction model was obtained by applying logistic regression analysis. Performance of the model was evaluated.
RESULTS: Twenty participants with HELLP were compared with 147 patients that developed PE without HELLP and 2810 controls. Women with HELLP were more likely Caucasian, nulliparous and presented a higher mean arterial pressure (MAP) when compared with controls. As opposing to women who developed HELLP, women who developed PE without HELLP were more likely of African-American origin and presented an even higher first-trimester MAP. Enrollment biochemical and biophysical parameters were similar between HELLP and PE or controls. Ethnicity, nulliparity, history of previous PE, history of previous HELLP syndrome, and first-trimester MAP were primary risk factors. A prediction rule for HELLP syndrome had an area under the curve of 0.80, with 75% sensitivity for 79% specificity.
CONCLUSION: The majority of pregnancies that develop HELLP syndrome can be predicted in the first trimester. © 2015 John Wiley & Sons, Ltd.