Evaluation of the role of serum markers and Doppler ultrasonography of uterine artery in predicting preeclampsia at the second trimester of pregnancy: A systematic review

Introduction: Preeclampsia is the most common medical complication in pregnancy. Regarding the pathophysiology and complex etiology of preeclampsia, a wide range of markers have been investigated. In addition to predictive value, identification of these factors may provide a clear mechanism for the pathogenesis of preeclampsia. This review study was performed with aim to evaluate the role of four serum markers and uterine artery Doppler ultrasonography in predicting preeclampsia at second trimester of pregnancy.

In this review study, the databases of SID, Weily online library, Elsevier, Scopus, Pubmed, and the Google Scholar search engine were used during 2000 to 2017 in order to find the relevant studies. To access all articles in English and Persian, the key words of BHCG, Inhibin A, Activin A, alpha-fetoprotein, serum markers, uterine artery Doppler sonography, second trimester, and preeclampsia prediction were used with all possible combinations of these words.

The results of various studies indicate that none of the studied markers, including AFP, β-HCG, INH-A and Activin A alone, do not provide predictive power for preeclampsia with high sensitivity and specificity. However, uterine artery Doppler ultrasonography at second trimester of pregnancy can be used as a screening test to predict preeclampsia in high risk women.

The most important strategies for prediction of preeclampsia include individual characteristics, uterine artery ultrasonography, and biomarkers. None of these markers alone can't predict preeclampsia with high sensitivity and specificity.