63 Addition of human placental lactogen cell free fetal rna as a marker of placental dysfunction may improves prediction of preeclampsia during first trimester

Introduction Preeclampsia (PE) is a pregnancy-specific disorder that complicates 5–7% of all pregnancies. In recent years, many methods have attempted to predict PE but they do not achieve detection rates good enough to be considered a screening test and used in a clinical setting. The placenta is crucial in pathogenesis of PE, and one of the hormone that is produced and released by the placenta is the human placental lactogen (hPL). hPL mRNA can be detected in plasma in all three trimester of pregnancy. Objective The objective of this study was to evaluate if the addition of hPL cell free mRNA (hPL cfmRNA) as a placental dysfunction biomarker improves the prediction of PE during the first trimester of pregnancy. Method A nested case-control study was conducted from a prospective cohort of pregnant women attending our institution for prenatal care at 11–14 weeks. From a total of 627 patients, cases (moderate PE (mPE) and severe PE (sPE)) and controls were selected. Clinical characteristic such as maternal age, history of hypertension, blood pressure and uterine artery pulsatility index (UtAPI) were measured. Total mRNA and protein from plasma samples at 11–14 weeks of gestation were purified. hPL cfmRNA levels were measured by quantitative reverse transcription PCR. Placental growth factor (PIGF) levels were measured by ELISA. Results Women with a normal pregnancy (control group 14) presented similar clinical characteristic in the first trimester of pregnancy compared with women who afterward developed mPE (4 patients). However, women who subsequently developed sPE were significantly older, had higher maternal weight, and higher blood pressure in comparison with women in the control group at 11–14 weeks ( p -value p -value p Conclusion The levels of hPL cfmRNA decrease at 11–14 weeks in patient that will develop PE. Addition of hPL cfmRNA could improve the prediction of PE at the first trimester of pregnancy when included in multiparametric models.