| Efficacy of midtrimester amniotic fluid 8-isoprostane measurement in the prediction of severe preeclampsia. |
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So Ra Kim, Pil Ryang Lee, Bon Sang Koo, Jong Soo Kim, Ji Youn Chung, Hye Sung Won, Ahm Kim |
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Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. |
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| Abstract |
OBJECTIVE
The objective of this study is to investigate whether the amniotic fluid 8-isoprostane levels at the time of genetic amniocentesis is a marker for severe preeclampsia. METHODS: A case-control study was conducted to compare mid-trimester concentrations of amniotic fluid 8-isoprostane in women with normal pregnancies (n=22) and in those who subsequently developed severe preeclampsia (n=22). Amniotic fluid was also obtained by amniocentesis from another women who already developed severe preeclampsia (n=22) after 20 weeks of gestation. The 8-isoprostane levels were measured by enzyme-linked immunoassay. For statistical analysis, nonparametric tests and receiver-operating characteristic curves were used where appropriate. Statistical significance was considered when probability was <0.05. RESULTS: The levels of midtrimester amniotic fluid 8-isoprostane were found to be significantly decreased in the women who subsequently developed severe preeclampsia in comparison with those who underwent normal pregnancies (P<0.05). The levels of 8-isoprostane in preeclamptic amniotic fluid were found to be significantly decreased with respect to that in midtrimester amniotic fluid (P<0.05). No relationship was found between the midtrimester amniotic fluid 8-isoprostane levels and preeclampsia with small-for- gestational-age. After the onset of severe preeclampsia, however, the amniotic fluid 8-isoprostane levels were significantly decreased in women with small-for-gestational-age. The midtrimester amniotic fluid 8-isoprostane level of 170 pg/ml had a sensitivity of 72.7% and a specificity of 63.6% in the prediction of severe preeclampsia. CONCLUSION: The midtrimester amniotic fluid 8-isoprostane levels may predict the later occurrence of severe preeclampsia. This study not only presents a new information that 8-isoprostane is detected in human amniotic fluid, but also provides a convincing evidence that a subclinical process from faulty placentation in early gestation is important for the occurrence of preeclampsia. Further studies are warranted to determine which mechanism causes such decrease in amniotic fluid 8-isoprostane in preeclampsia. |
| Key Words:
8-isoprostane, preeclampsia, amniotic fluid, predictive marker |
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