الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 115 |  |  |
| | | from | 115 | | |
Abstract
The worldwide prevalence of pre-eclampsia is 3.8% in pregnant women, and it is responsible for more than 70,000 maternal and 500,000 foetal deaths each year
The main aim of this study was to investigate the correlation between urine transcription factor 21 and pre-eclampsia patient and those with normotensive pregnancies and to compare these levels in early onset versus late onset disease as well as mild pre-eclampsia with full-term delivery and severe disease with preterm delivery.
This study included 224 pregnant women in child bearing period (aged 18-41 years) with a gestational age of 24-37 weeks. They were classified into 2 groups:
group I (pre-eclampsia group)
They included 160 patients who were subdivided into
group Ia that included 92 pregnant women with mild pre-eclampsia& subdivided into 48 patients age of <34 weeks and 44 patients age of >34 weeks
group Ib that included 68 pregnant women with severe pre-eclampsia and subdivided PE 32 patients age of <34 weeks and 36 patients age of >34 weeks
group II (Control Group):
64 healthy, normotensive pregnant women without hypertension and proteinuria served as control subjects.
The main results of this study
There is no difference between both groups (normotensive pregnant group & pre-eclampsia group) as regard age gravidity (p = 0.107) and parity (p = 0.992).
We found Pregnant patients with pre-eclampsia had higher incidence of abortion (p = 0.007*)
This study revealed that the patients with pre-eclampsia had a higher heart rate (p <0.001), systolic blood pressure (p <0.001), diastolic blood pressure (p <0.001), higher incidence of lower limb edema (p <0.001) and convulsions (p = 0.004) compared to normotensive women
In this study, the platelet count was lower (140.000 - 260.000 vs. 229.000 - 330.000; p <0.001) and INR was statistically significant higher in the pregnant patients with pre-eclampsia (1.133 0.246 vs. 1.03 0.04, p <0.001) compared to control group.
We found serum creatinine and blood urea were statistically significant higher in pregnant patients with pre-eclampsia (0.7 - 1.0 vs. 0.4 - 0.6, p <0.001 and 23 - 37.8 vs. 20 - 23, p <0.001 respectively).
For aminotransferases, both ALT and AST showed statistically significant difference between study groups being higher in pregnant patients with pre-eclampsia (15 – 32.3 vs. 11 - 13, p <0.001 and 16 - 35 vs. 14 - 16, p <0.001respectively).
In assessment of proteinuria, we found the dipstick urine albumin and spot urine protein creatinine ratio were statistically significant higher in pregnant patients with pre-eclampsia (0 vs 2 - 3, p <0.001; 0.07 - 0.1 vs. 0.6 - 2.1, p <0.001 respectively)
Of the studied biomarkers, serum sFlt-1 and the sFlt-1/PlGF ratio were statistically significant higher in pregnant patients with pre-eclampsia (4264.2 ± 804.5 vs. 373.4 ± 62.7, p <0.001; 73.1 ± 66.5 vs. 1.8 ± 0.6, p <0.001 respectively).
In this study, the urine TCF21 was statistically significant higher in pregnant patients with pre-eclampsia (512.3 ± 281.4 vs. 300 ± 66.8; p <0.001 )
We found no association between the urine TCF21 and any studied parameters except weak positive correlation with platelet count (r = 0.194, p = 0.14), weak negative correlation with diastolic blood pressure, and incidence of fits (r = -0.244, p = 0.002; r = -0.193, p = 0.14 respectively) and fair negative correlation with pre-eclampsia severity (r = -0.258, p <0.001)
This study couldn’t differentiate between early-onset and late-onset pre-eclampsia by the studied biomarkers (serum sFlt-1, serum PlGF, the sFlt-1/PlGF ratio, and urine TCF21)
In this study, we found the mean urine TCF21 is markedly reduced in pregnant patients with severe pre-eclampsia as compared to pregnant patients with mild pre-eclampsia (361.9 ± 155.8 vs. 572.3 ± 300.9; p <0.001).
Also the mean sFlt-1/PlGF ratio is increased in pregnant patients with severe pre-eclampsia as compared to pregnant patients with mild pre-eclampsia but does not reach a statistical significance (361.9 ± 155.8 vs. 572.3 ± 300.9; p =0.16),
We found that urine TCF21 is helpful in prediction of pre-eclampsia better than serum sFlt-1 but not superior to serum PlGF
In this study, the urine TCF21 could be used as a potential diagnostic test for pre-eclampsia.The (ROC) curve showed that the urine TCF21 at a cutoff value of > 370 has 60% sensitivity and 90% specificity, and the area under the curve was 0.769 (p<0.001, ). As compared to serum sFlt-1 and serum PlGF, the urine TCF21 had the highest specificity but lowest sensitivity.
Pregnant patients with pre-eclampsia had a higher incidence of IUGR by (p=0.015) and poor placental blood flow (p=0.041) in comparison with normal cases
CONCLUSION
from findings of our results, we can conclude that the urine TCF21 could be used as a diagnostic and predictive biomarker for pre-eclampsia.