American Journal of Obstetrics & Gynecology
Volume 199, Issue 2 , Pages 122.e1-122.e11 , August 2008

First-trimester maternal serum PP13 in the risk assessment for preeclampsia

Presented at the 27th Annual Meeting of the Society for Maternal-Fetal Medicine, San Francisco, CA, Feb. 5-10, 2007.

  • Roberto Romero, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI
    • Corresponding Author InformationReprints: Roberto Romero, MD, Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Wayne State University/Hutzel Women's Hospital, 3990 John R, Box 4, Detroit, MI 48201.
    • ,
  • Juan Pedro Kusanovic, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Nandor Gabor Than, MD, PhD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • First Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
    • ,
  • Offer Erez, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • ,
  • Francesca Gotsch, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • ,
  • Jimmy Espinoza, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Samuel Edwin, PhD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • ,
  • Ilana Chefetz, MSc

      Affiliations

    • Diagnostic Technologies, Yokneam, Israel
    • ,
  • Ricardo Gomez, MD

      Affiliations

    • Center for Perinatal Diagnosis and Research, Sótero del Río Hospital, P. Universidad Católica de Chile, Puente Alto, Chile
    • ,
  • Jyh Kae Nien, MD

      Affiliations

    • Center for Perinatal Diagnosis and Research, Sótero del Río Hospital, P. Universidad Católica de Chile, Puente Alto, Chile
    • ,
  • Marei Sammar, PhD

      Affiliations

    • Diagnostic Technologies, Yokneam, Israel
    • ,
  • Beth Pineles, BS

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • ,
  • Sonia S. Hassan, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Hamutal Meiri, PhD

      Affiliations

    • Diagnostic Technologies, Yokneam, Israel
    • ,
  • Yossi Tal, PhD

      Affiliations

    • TechnoSTAT, Kfar Sabah, Israel
    • ,
  • Ido Kuhnreich, MSc

      Affiliations

    • TechnoSTAT, Kfar Sabah, Israel
    • ,
  • Zoltan Papp, MD, DSci

      Affiliations

    • First Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
    • ,
  • Howard S. Cuckle, PhD

      Affiliations

    • Leeds Screening Centre, University of Leeds, Leeds, UK
    • Department of Obstetrics and Gynecology, Columbia University, New York, NY.

Received 9 July 2007 ,Revised 17 October 2007 ,Accepted 11 January 2008.

References 

  1. Sibai BM, Ewell M, Levine RJ, et al. The Calcium for Preeclampsia Prevention (CPEP) Study Group Risk factors associated with preeclampsia in healthy nulliparous women. Am J Obstet Gynecol. 1997;177:1003–1010
  2. Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol. 1998;179:1359–1375
  3. Confidential Enquiries in Maternal Deaths (Why Mothers Die 1997-1999). London: RCOG Press; 2002;
  4. Sibai BM, Caritis S, Hauth J. What we have learned about preeclampsia. Semin Perinatol. 2003;27:239–246
  5. National Institute for Clinical Excellence. Routine antenatal care for healthy pregnant woman. London: National Institute for Clinical Excellence; 2003;
  6. Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365:785–799
  7. Dekker GA, de Vries JI, Doelitzsch PM, et al. Underlying disorders associated with severe early-onset preeclampsia. Am J Obstet Gynecol. 1995;173:1042–1048
  8. Myatt L, Miodovnik M. Prediction of preeclampsia. Semin Perinatol. 1999;23:45–57
  9. Odegard RA, Vatten LJ, Nilsen ST, Salvesen KA, Austgulen R. Preeclampsia and fetal growth. Obstet Gynecol. 2000;96:950–955
  10. Murphy DJ, Stirrat GM. Mortality and morbidity associated with early-onset preeclampsia. Hypertens Pregnancy. 2000;19:221–231
  11. Xiong X, Demianczuk NN, Saunders LD, Wang FL, Fraser WD. Impact of preeclampsia and gestational hypertension on birth weight by gestational age. Am J Epidemiol. 2002;155:203–209
  12. von Dadelszen P, Magee LA, Roberts JM. Subclassification of preeclampsia. Hypertens Pregnancy. 2003;22:143–148
  13. Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science. 2005;308:1592–1594
  14. Bhattacharya S, Campbell DM. The incidence of severe complications of preeclampsia. Hypertens Pregnancy. 2005;24:181–190
  15. Gaugler-Senden IP, Huijssoon AG, Visser W, Steegers EA, de Groot CJ. Maternal and perinatal outcome of preeclampsia with an onset before 24 weeks' gestation (Audit in a tertiary referral center). Eur J Obstet Gynecol Reprod Biol. 2006;128:216–221
  16. Espinoza J, Romero R, Nien JK, et al. Identification of patients at risk for early onset and/or severe preeclampsia with the use of uterine artery Doppler velocimetry and placental growth factor. Am J Obstet Gynecol. 2007;196:326.e1–326.e13
  17. Borzychowski AM, Sargent IL, Redman CW. Inflammation and pre-eclampsia. Semin Fetal Neonatal Med. 2006;11:309–316
  18. Goswami D, Tannetta DS, Magee LA, et al. Excess syncytiotrophoblast microparticle shedding is a feature of early-onset pre-eclampsia, but not normotensive intrauterine growth restriction. Placenta. 2006;27:56–61
  19. Knight M, Redman CW, Linton EA, Sargent IL. Shedding of syncytiotrophoblast microvilli into the maternal circulation in pre-eclamptic pregnancies. Br J Obstet Gynaecol. 1998;105:632–640
  20. Myatt L. Role of placenta in preeclampsia. Endocrine. 2002;19:103–111
  21. Redman CW, Sargent IL. Placental debris, oxidative stress and pre-eclampsia. Placenta. 2000;21:597–602
  22. Redman CW, Sargent IL. The pathogenesis of pre-eclampsia. Gynecol Obstet Fertil. 2001;29:518–522
  23. Campbell S, Diaz-Recasens J, Griffin DR, et al. New doppler technique for assessing uteroplacental blood flow. Lancet. 1983;1:675–677
  24. Harrington KF, Campbell S, Bewley S, Bower S. Doppler velocimetry studies of the uterine artery in the early prediction of pre-eclampsia and intra-uterine growth retardation. Eur J Obstet Gynecol Reprod Biol. 1991;42(Suppl):S14–S20
  25. Bower S, Schuchter K, Campbell S. Doppler ultrasound screening as part of routine antenatal scanning: Prediction of pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol. 1993;100:989–994
  26. Harrington K, Cooper D, Lees C, Hecher K, Campbell S. Doppler ultrasound of the uterine arteries: The importance of bilateral notching in the prediction of pre-eclampsia, placental abruption or delivery of a small-for-gestational-age baby. Ultrasound Obstet Gynecol. 1996;7:182–188
  27. Albaiges G, Missfelder-Lobos H, Lees C, Parra M, Nicolaides KH. One-stage screening for pregnancy complications by color Doppler assessment of the uterine arteries at 23 weeks' gestation. Obstet Gynecol. 2000;96:559–564
  28. Papageorghiou AT, Yu CK, Bindra R, Pandis G, Nicolaides KH. Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation. Ultrasound Obstet Gynecol. 2001;18:441–449
  29. Granger JP, Alexander BT, Llinas MT, Bennett WA, Khalil RA. Pathophysiology of preeclampsia: Linking placental ischemia/hypoxia with microvascular dysfunction. Microcirculation. 2002;9:147–160
  30. Papageorghiou AT, Yu CK, Nicolaides KH. The role of uterine artery Doppler in predicting adverse pregnancy outcome. Best Pract Res Clin Obstet Gynaecol. 2004;18:383–396
  31. Papageorghiou AT, Yu CK, Cicero S, Bower S, Nicolaides KH. Second-trimester uterine artery Doppler screening in unselected populations: A review. J Matern Fetal Neonatal Med. 2002;12:78–88
  32. Brosens IA, Robertson WB, Dixon HG. The role of the spiral arteries in the pathogenesis of preeclampsia. Obstet Gynecol Annu. 1972;1:177–191
  33. Brosens IA, Robertson WB, Dixon HG. The role of the spiral arteries in the pathogenesis of pre-eclampsia. J Pathol. 1970;101:vi
  34. Khong TY, De WF, Robertson WB, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J Obstet Gynaecol. 1986;93:1049–1059
  35. Pijnenborg R, Anthony J, Davey DA, et al. Placental bed spiral arteries in the hypertensive disorders of pregnancy. Br J Obstet Gynaecol. 1991;98:648–655
  36. Meekins JW, Pijnenborg R, Hanssens M, McFadyen IR, van AA. A study of placental bed spiral arteries and trophoblast invasion in normal and severe pre-eclamptic pregnancies. Br J Obstet Gynaecol. 1994;101:669–674
  37. Brosens JJ, Pijnenborg R, Brosens IA. The myometrial junctional zone spiral arteries in normal and abnormal pregnancies: a review of the literature. Am J Obstet Gynecol. 2002;187:1416–1423
  38. Fisher SJ. The placental problem: linking abnormal cytotrophoblast differentiation to the maternal symptoms of preeclampsia. Reprod Biol Endocrinol. 2004;2:53
  39. Lyall F. Priming and remodelling of human placental bed spiral arteries during pregnancy—a review. Placenta. 2005;26(Suppl A):S31–S36
  40. Sargent IL, Borzychowski AM, Redman CW. Immunoregulation in normal pregnancy and pre-eclampsia: an overview. Reprod Biomed Online. 2006;13:680–686
  41. Kadyrov M, Kingdom JC, Huppertz B. Divergent trophoblast invasion and apoptosis in placental bed spiral arteries from pregnancies complicated by maternal anemia and early-onset preeclampsia/intrauterine growth restriction. Am J Obstet Gynecol. 2006;194:557–563
  42. Espinoza J, Romero R, Mee KY, et al. Normal and abnormal transformation of the spiral arteries during pregnancy. J Perinat Med. 2006;34:447–458
  43. Robertson WB, Brosens I, Dixon G. Maternal uterine vascular lesions in the hypertensive complications of pregnancy. Perspect Nephrol Hypertens. 1976;5:115–127
  44. Brosens IA. Morphological changes in the utero-placental bed in pregnancy hypertension. Clin Obstet Gynaecol. 1977;4:573–593
  45. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103:981–991
  46. Barton JR, Sibai BM. Diagnosis and management of hemolysis, elevated liver enzymes, and low platelets syndrome. Clin Perinatol. 2004;31:807–833vii
  47. Egerman RS, Sibai BM. HELLP syndrome. Clin Obstet Gynecol. 1999;42:381–389
  48. Abramovici D, Friedman SA, Mercer BM, Audibert F, Kao L, Sibai BM. Neonatal outcome in severe preeclampsia at 24 to 36 weeks' gestation: does the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome matter?. Am J Obstet Gynecol. 1999;180:221–225
  49. Tikkanen M, Nuutila M, Hiilesmaa V, Paavonen J, Ylikorkala O. Clinical presentation and risk factors of placental abruption. Acta Obstet Gynecol Scand. 2006;85:700–705
  50. Lindqvist PG, Happach C. Risk and risk estimation of placental abruption. Eur J Obstet Gynecol Reprod Biol. 2006;126:160–164
  51. Toivonen S, Heinonen S, Anttila M, Kosma VM, Saarikoski S. Reproductive risk factors, Doppler findings, and outcome of affected births in placental abruption: a population-based analysis. Am J Perinatol. 2002;19:451–460
  52. Ananth CV, Smulian JC, Vintzileos AM. Incidence of placental abruption in relation to cigarette smoking and hypertensive disorders during pregnancy: a meta-analysis of observational studies. Obstet Gynecol. 1999;93:622–628
  53. Thadhani R, Mutter WP, Wolf M, et al. First trimester placental growth factor and soluble fms-like tyrosine kinase 1 and risk for preeclampsia. J Clin Endocrinol Metab. 2004;89:770–775
  54. Chaiworapongsa T, Romero R, Kim YM, et al. Plasma soluble vascular endothelial growth factor receptor-1 concentration is elevated prior to the clinical diagnosis of pre-eclampsia. J Matern Fetal Neonatal Med. 2005;17:3–18
  55. Bujold E, Romero R, Chaiworapongsa T, et al. Evidence supporting that the excess of the sVEGFR-1 concentration in maternal plasma in preeclampsia has a uterine origin. J Matern Fetal Neonatal Med. 2005;18:9–16
  56. Lyall F, Greer IA, Boswell F, Fleming R. Suppression of serum vascular endothelial growth factor immunoreactivity in normal pregnancy and in pre-eclampsia. Br J Obstet Gynaecol. 1997;104:223–228
  57. Kupferminc MJ, Daniel Y, Englender T, et al. Vascular endothelial growth factor is increased in patients with preeclampsia. Am J Reprod Immunol. 1997;38:302–306
  58. Tsatsaris V, Goffin F, Munaut C, et al. Overexpression of the soluble vascular endothelial growth factor receptor in preeclamptic patients: Pathophysiological consequences. J Clin Endocrinol Metab. 2003;88:5555–5563
  59. Maynard SE, Min JY, Merchan J, et al. Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J Clin Invest. 2003;111:649–658
  60. Koga K, Osuga Y, Yoshino O, Hirota Y, Ruimeng X, Hirata T, et al. Elevated serum soluble vascular endothelial growth factor receptor 1 (sVEGFR-1) levels in women with preeclampsia. J Clin Endocrinol Metab. 2003;88:2348–2351
  61. Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004;350:672–683
  62. McKeeman GC, Ardill JE, Caldwell CM, Hunter AJ, McClure N. Soluble vascular endothelial growth factor receptor-1 (sFlt-1) is increased throughout gestation in patients who have preeclampsia develop. Am J Obstet Gynecol. 2004;191:1240–1246
  63. Chaiworapongsa T, Romero R, Espinoza J, et al. Evidence supporting a role for blockade of the vascular endothelial growth factor system in the pathophysiology of preeclampsia (Young Investigator Award). Am J Obstet Gynecol. 2004;190:1541–1547
  64. Staff AC, Braekke K, Harsem NK, Lyberg T, Holthe MR. Circulating concentrations of sFlt1 (soluble fms-like tyrosine kinase 1) in fetal and maternal serum during pre-eclampsia. Eur J Obstet Gynecol Reprod Biol. 2005;122:33–39
  65. Shibata E, Rajakumar A, Powers RW, et al. Soluble fms-like tyrosine kinase 1 is increased in preeclampsia but not in normotensive pregnancies with small-for-gestational-age neonates: relationship to circulating placental growth factor. J Clin Endocrinol Metab. 2005;90:4895–4903
  66. Rajakumar A, Michael HM, Rajakumar PA, et al. Extra-placental expression of vascular endothelial growth factor receptor-1, (Flt-1) and soluble Flt-1 (sFlt-1), by peripheral blood mononuclear cells (PBMCs) in normotensive and preeclamptic pregnant women. Placenta. 2005;26:563–573
  67. Maynard SE, Venkatesha S, Thadhani R, Karumanchi SA. Soluble Fms-like tyrosine kinase 1 and endothelial dysfunction in the pathogenesis of preeclampsia. Pediatr Res. 2005;57:1R–7R
  68. Stepan H, Faber R. Elevated sFlt1 level and preeclampsia with parvovirus-induced hydrops. N Engl J Med. 2006;354:1857–1858
  69. Girardi G, Yarilin D, Thurman JM, Holers VM, Salmon JE. Complement activation induces dysregulation of angiogenic factors and causes fetal rejection and growth restriction. J Exp Med. 2006;203:2165–2175
  70. Levine RJ, Lam C, Qian C, et al. Soluble endoglin and other circulating antiangiogenic factors in preeclampsia. N Engl J Med. 2006;355:992–1005
  71. Espinoza J, Romero R, Nien JK, et al. A role of the anti-angiogenic factor sVEGFR-1 in the ‘mirror syndrome’ (Ballantyne's syndrome). J Matern Fetal Neonatal Med. 2006;19:607–613
  72. Crispi F, Dominguez C, Llurba E, Martin-Gallan P, Cabero L, Gratacos E. Placental angiogenic growth factors and uterine artery Doppler findings for characterization of different subsets in preeclampsia and in isolated intrauterine growth restriction. Am J Obstet Gynecol. 2006;195:201–207
  73. Robinson CJ, Johnson DD, Chang EY, Armstrong DM, Wang W. Evaluation of placenta growth factor and soluble Fms-like tyrosine kinase 1 receptor levels in mild and severe preeclampsia. Am J Obstet Gynecol. 2006;195:255–259
  74. Tjoa ML, Levine RJ, Karumanchi SA. Angiogenic factors and preeclampsia. Front Biosci. 2007;12:2395–2402
  75. Ohkuchi A, Hirashima C, Matsubara S, et al. Alterations in placental growth factor levels before and after the onset of preeclampsia are more pronounced in women with early onset severe preeclampsia. Hypertens Res. 2007;30:151–159
  76. Muller PR, James AH, Murtha AP, Yonish B, Jamison MG, Dekker G. Circulating angiogenic factors and abnormal uterine artery Doppler velocimetry in the second trimester. Hypertens Pregnancy. 2006;25:183–192
  77. Torry DS, Wang HS, Wang TH, Caudle MR, Torry RJ. Preeclampsia is associated with reduced serum levels of placenta growth factor. Am J Obstet Gynecol. 1998;179:1539–1544
  78. Tidwell SC, Ho HN, Chiu WH, Torry RJ, Torry DS. Low maternal serum levels of placenta growth factor as an antecedent of clinical preeclampsia. Am J Obstet Gynecol. 2001;184:1267–1272
  79. Krauss T, Pauer HU, Augustin HG. Prospective analysis of placenta growth factor (PlGF) concentrations in the plasma of women with normal pregnancy and pregnancies complicated by preeclampsia. Hypertens Pregnancy. 2004;23:101–111
  80. Levine RJ, Thadhani R, Qian C, et al. Urinary placental growth factor and risk of preeclampsia. JAMA. 2005;293:77–85
  81. Aggarwal PK, Jain V, Sakhuja V, Karumanchi SA, Jha V. Low urinary placental growth factor is a marker of pre-eclampsia. Kidney Int. 2006;69:621–624
  82. Bersinger NA, Odegard RA. Second- and third-trimester serum levels of placental proteins in preeclampsia and small-for-gestational age pregnancies. Acta Obstet Gynecol Scand. 2004;83:37–45
  83. Zwahlen M, Gerber S, Bersinger NA. First trimester markers for pre-eclampsia: placental vs. non-placental protein serum levels. Gynecol Obstet Invest. 2007;63:15–21
  84. Venkatesha S, Toporsian M, Lam C, et al. Soluble endoglin contributes to the pathogenesis of preeclampsia. Nat Med. 2006;12:642–649
  85. Masuyama H, Nakatsukasa H, Takamoto N, Hiramatsu Y. Correlation between soluble endoglin, vascular endothelial growth factor receptor −1 and adipocytokines in preeclampsia. J Clin Endocrinol Metab. 2007;92:2672–2679
  86. Lopez-Novoa JM. Soluble endoglin is an accurate predictor and a pathogenic molecule in pre-eclampsia. Nephrol Dial Transplant. 2007;22:712–714
  87. Luft FC. Soluble endoglin (sEng) joins the soluble fms-like tyrosine kinase (sFlt) receptor as a pre-eclampsia molecule. Nephrol Dial Transplant. 2006;21:3052–3054
  88. Slaghekke F, Dekker G, Jeffries B. Endogenous inhibitors of nitric oxide and preeclampsia: A review. J Matern Fetal Neonatal Med. 2006;19:447–452
  89. Bohn H, Kraus W, Winckler W. Purification and characterization of two new soluble placental tissue proteins (PP13 and PP17). Oncodev Biol Med. 1983;4:343–350
  90. Than GN, Bohn H, Szabo DG. Advances in pregnancy related protein research. Boca Raton: CRC press; 1993;1-333
  91. Than NG, Sumegi B, Than GN, Berente Z, Bohn H. Isolation and sequence analysis of a cDNA encoding human placental tissue protein 13 (PP13), a new lysophospholipase, homologue of human eosinophil Charcot-Leyden Crystal protein. Placenta. 1999;20:703–710
  92. Burger O, Pick E, Zwickel J, et al. Placental protein 13 (PP-13): Effects on cultured trophoblasts, and its detection in human body fluids in normal and pathological pregnancies. Placenta. 2004;25:608–622
  93. Visegrady B, Than NG, Kilar F, Sumegi B, Than GN, Bohn H. Homology modelling and molecular dynamics studies of human placental tissue protein 13 (galectin-13). Protein Eng. 2001;14:875–880
  94. Than NG, Pick E, Bellyei S, et al. Functional analyses of placental protein 13/galectin-13. Eur J Biochem. 2004;271:1065–1078
  95. Than NG, Rahman OA, Kovats T, et al. PP13 expression is altered in preeclampsia. J Soc Gynecol Invest. 2006;13(Suppl 2):128A
  96. Nicolaides KH, Bindra R, Turan OM, et al. A novel approach to first-trimester screening for early pre-eclampsia combining serum PP-13 and Doppler ultrasound. Ultrasound Obstet Gynecol. 2006;27:13–17
  97. Spencer K, Cowans NJ, Chefetz I, Tal J, Meiri H. First-trimester maternal serum PP-13, PAPP-A and second-trimester uterine artery Doppler pulsatility index as markers of pre-eclampsia. Ultrasound Obstet Gynecol. 2007;29:128–134
  98. Wolf M, Shah A, Jimenez-Kimble R, Sauk J, Ecker JL, Thadhani R. Differential risk of hypertensive disorders of pregnancy among Hispanic women. J Am Soc Nephrol. 2004;15:1330–1338
  99. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183:S1–S22
  100. Gonzalez RP, Gomez RM, Castro RS, et al. A national birth weight distribution curve according to gestational age in Chile from 1993 to 2000. Rev Med Chil. 2004;132:1155–1165
  101. Cuckle HS, Wald N. Testing using single markers. In:  Wald N,  Leck I editor. Antenatal and neonatal screening. 2nd ed.. Oxford (UK): Oxford University Press; 2000;p. 1–22
  102. Rasmussen S, Irgens LM. Fetal growth and body proportion in preeclampsia. Obstet Gynecol. 2003;101:575–583
  103. Gonen R. PP13 as an early marker for preeclampsia. J Prenatal Med. 2007;35(Suppl 2):S24–S25

 Cite this article as: Romero R, Kusanovic JP, Than NG, et al. First-trimester maternal serum PP13 in the risk assessment for preeclampsia. Am J Obstet Gynecol 2008;199:122.e1-122.e11.

 This research was supported, in part, by the Intramural Research Program of the National Institute of Child Health and Human Development, Eunice Kennedy Shriver National Institutes of Health, Department of Health and Human Services, and Grants 31851 and 42872 from Israel Chief Scientist (to H.M.).

PII: S0002-9378(08)00028-8

doi: 10.1016/j.ajog.2008.01.013

American Journal of Obstetrics & Gynecology
Volume 199, Issue 2 , Pages 122.e1-122.e11 , August 2008

Article Tools

* Image Usage & Resolution