الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks’ gestation and can present as late as 4-6 weeks postpartum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema. Pre-eclampsia contributes substantially to perinatal morbidity and mortality of both, mother and newborn.
Preeclampsia is mild in 75% of cases and severe in 25% of them. In its extreme, the disease may lead to liver and renal failure, disseminated intravascular coagulopathy (DIC), and central nervous system (CNS) abnormalities. If preeclampsia-associated seizures develop, the disorder has developed into the condition called eclampsia.
Measurement in early pregnancy of a variety of biochemical and biophysical markers implicated in the pathophysiology of preeclampsia has been proposed to predict its development. Investigators have attempted to identify early markers of reduced placental perfusion, endothelial cell activation and dysfunction and activation of coagulation.
Pregnancy-associated plasma protein A, (PAPP-A) is a large highly glycosylated protein complex. It was first shown to be elevated in the plasma of preeclamptic women nearly 30 years ago. Reduced first trimester serum levels of PAPP-A are associated with preeclampsia, levels are also low in other complications of pregnancy.
The aim of this study was to correlate the level of maternal serum pregnancy associated plasma protein A in the first trimester with the risk of pre-eclampsia.
Our study was conducted in the El-shatby maternity university hospital. The study included 100 pregnant women in the first trimester of pregnancy (8 -12 weeks of gestation) they were divided into two groups : group A consisted of 50 women with high risk of pre-eclampsia (such as : history of pre eclampsia , diabetic , renal diseases ,essential hypertensive , autoimmune diseases , old primigravida ( ≥ 35 years ) and primigravida with positive consanguinity . Group B consisted of 50 normotensive women and who remained with normal blood pressure throughout gestation with no risk factors. The group served as a control group
Finally, Identification of women at high risk for PE could potentially improve pregnancy outcome because intensive maternal and fetal monitoring in such patients would lead to an earlier diagnosis of the clinical signs of the disease and the associated fetal growth restriction and avoid the development of serious complications through such interventions as the administration of antihypertensive medication and early delivery.
The proposed screening test could also be used for effective identification of the high-risk group for future studies investigating the potential role of pharmacological interventions starting from the first trimester to improve placentation and reduce the prevalence of the disease.
Serum PAPPA in the first trimester (11-13 week) has a predictor value in detection of pre-eclampsia.