Second trimester maternal serum D-dimer combined with alpha-fetoprotein and free ß-subunit of human chorionic gonadotropin predict hypertensive disorders of pregnancy: a systematic review and retrospective case-control study.
J Transl Med
; 19(1): 94, 2021 03 02.
Article
in En
| MEDLINE
| ID: mdl-33653375
ABSTRACT
BACKGROUND:
This study investigated whether maternal serum D-dimer (DD) alone or DD combined with alpha-fetoprotein (AFP) and free ß-subunit of human chorionic gonadotropin (free ß-hCG) in the second trimester could be used to predict hypertensive disorders of pregnancy (HDP). MATERIALS ANDMETHODS:
In this retrospective case-control study, the data of gravidas patients who delivered at hospital were divided into the following groups control (n = 136), gestational hypertension (GH, n = 126), preeclampsia (PE, n = 53), and severe preeclampsia (SPE, n = 41). Receiver operator characteristic (ROC) curves were used to evaluate the diagnostic value of maternal serum DD, AFP, and free ß-hCG levels for HDP.RESULTS:
DD levels of the GH, PE, and SPE groups were significantly higher than that of the control group (P < 0.001). The order of effectiveness for models predicting HDP was as follows DD + AFP + free ß-hCG > DD > DD + AFP > DD + free ß-hCG > AFP + free ß-hCG > AFP > free ß-hCG. For predicting different types of HDP, DD alone had the best diagnostic value for SPE, followed by PE and GH. DD alone had a sensitivity of 100% with a 0% false negative rate and had the highest positive likelihood ratio (+ LR) for SPE. DD alone in combination with AFP alone, free ß-hCG alone and AFP + free ß-hCG could reduce false positive rate and improve + LR.CONCLUSION:
DD is possible the best individual predictive marker for predicting HDP. Levels of DD alone in the second trimester were positively correlated with the progression of elevated blood pressure in the third trimester, demonstrating the predicting the occurrence of HDP. The risk calculation model constructed with DD + free ß-hCG + AFP had the greatest diagnostic value for SPE.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Pre-Eclampsia
/
Hypertension, Pregnancy-Induced
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Systematic_reviews
Limits:
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
J Transl Med
Year:
2021
Type:
Article
Affiliation country:
China