DOI: 10.4103/npmj.npmj_232_23 ISSN: 1117-1936

Added Value of Mean Blood Pressure and Placental Growth Factor in the Early Detection of Pre-eclampsia among Gabonese Women

Elisabeth Lendoye, Ulysse Pascal Minkobame, Opheelia Makoyo Komba, Pamphile Assoumou Obiang, Luce Nkene Eya'a, Ulrich Bisvigou, Lydie Moukambi, Bénédicte Ndeboko, Jacques Albert Bang Ntamack, Edgard Brice Ngoungou, Joël Fleury Djoba Siawaya, Félix Ovono Abessolo, Jean François Meyé
  • General Medicine

Abstract

Objective:

To evaluate the use of the Foetal Medicine Foundation (FMF) algorithm in routine practice for early pre-eclampsia (PE) screening in Libreville.

Materials and Methods:

We conducted a cohort study on pregnant women within their 11–13 + 6 weeks of gestation (WG). We had measured mean blood pressure (MBP), placental growth factor (PlGF), soluble Fms-like tyrosine kinase 1, Uterine Artery Pulsatility Index (UtA-PI) and resistance index (UtA-RI). Statistical analyses were considered significant for P < 0.05.

Results:

There were 30 participants. At the first quarter (T1), 36.7% of them were at high risk of PE according to the FMF algorithm and were consequently prescribed aspirin (100 mg/d). By the end of the observation period, we have found a 13% incidence of PE. MBP was higher in the higher risk PE group than in the lower risk group as early as the T1 (90 ± 6 vs. 81 ± 6 mmHg; P = 0.0007, threshold is >86 mmHg/area under the curve (AUC) = 0.86; P = 0.0012). It was the same for PlGF (58 ± 24 vs. 88 ± 38 pg/ml; P = 0.03; threshold is <71.98 pg/ml/AUC = 0.73; P = 0.03). At the second quarter (20–27 WG), biochemical markers did not change between the two groups. UtA-RI, UtA-PI and notch were unconclusive individually, but they are still very important for FMF algorithm application.

Conclusion:

Early detection of PE using the FMF algorithm is possible in routine practice in Gabon. MBP and PlGF levels at T1 seem to be very significant. However, the present study must continue to obtain the larger cohorts that would achieve more conclusive statistical analyses.

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