Combined use of serum gamma glutamyl transferase level and ultrasonography improves prediction of perinatal outcomes associated with preeclamptic pregnancy.

INTRODUCTION: Serum gamma glutamyl transferase (GGT), produced and released mostly from the liver and bile duct, is an enzyme involved in response to oxidative stress, and has been used as a maker for prediction of cardiovascular events. Umbilical artery blood flow resistance index, e.g., the systolic/diastolic ratio (S/D ratio) as determined by ultrasound, has been used to assess the fetal intrauterine conditions. While changes of GGT and S/D ratio in preeclampsia are found to be associated with the risk for adverse perinatal outcome, the potential value of combined use of the two measurements for the prediction of adverse perinatal outcome has not been determined.

MATERIALS AND METHODS: This study included severe preeclampsia patients in late pregnancy and determined their serum GGT levels and ultrasonic flow resistance index of umbilical artery within a week before delivery. Demographic data and perinatal outcomes including perinatal death, five-minute Apgar score, admission to neonatal intensive care unit, respiratory distress syndrome, and intrauterine growth restriction, are documented and analyzed.

RESULTS: It was found that serum GGT combined with umbilical artery S/D ratio predicted perinatal adverse outcomes in severe preeclampsia patients with a sensitivity of 94.30% and a specificity of 80.00%. Moreover, absent or reversed UA diastolic blood flow was found to be an independent risk factor for intrauterine growth restriction.

CONCLUSION: GGT in combination with umbilical artery S/D ratio is a potentially useful marker for the prediction of adverse outcome in severe preeclampsia patients. Future studies in a larger cohort of patients should be performed to verify the efficacy of the strategy. Early and accurate prediction of adverse perinatal events can facilitate the efforts to improve the perinatal outcomes of neonates associated with preeclamptic pregnancies.