Lukic, R. (6603430390)R. (6603430390)LukicDjukic, M. (57208476700)M. (57208476700)DjukicSoldatovic, I. (35389846900)I. (35389846900)SoldatovicKaradzov Orlic, N. (41561546900)N. (41561546900)Karadzov OrlicArdalic, D. (6506626952)D. (6506626952)ArdalicDragovic, G. (23396934400)G. (23396934400)DragovicMikovic, Z. (7801694296)Z. (7801694296)Mikovic2025-06-122025-06-122017https://doi.org/10.12891/ceog3534.2017https://www.scopus.com/inward/record.uri?eid=2-s2.0-85037058653&doi=10.12891%2fceog3534.2017&partnerID=40&md5=2909f4b5893bd016b3792a7f31b61cf4https://remedy.med.bg.ac.rs/handle/123456789/7235Purpose of investigation: The objective of this study was to predict preeclampsia using extreme-low first-trimester pregnancy-associated- plasma-protein-A-(PAPP-A), extreme-low free-beta-human-chorionic-gonadotropin-(free-βhCG)-levels, and extreme-high pulsatility- index (PI) of uterine arteries, as single and combined predictors for preeclampsia development in resource-limited-settings. Materials and Methods: First-trimester screening for PAPP A, free-βhCG, and PI was performed between 11-13 +6 gestation-weeks in nulliparous, normotensive women with singleton pregnancy with extremely-low PAPP-A (PAPP-A ≤ 0.52 MoM), extremely-low free- βhCG (free-βhCG ≤ 0.56 MoM) and extremely-high PI (≥ 2.52). Results: Of 85 pregnant women, 14 (16.5%) developed preeclampsia. PAPP-A ≤ 0.52 MoM and PI ≥ 2.52, as a single categorical variables, found to be with high OR for preeclampsia-development (OR = 7.07, 95% CI = 0.873-57.204, p = 0.067; OR = 5.098, 95% CI = 0.625-41.575, p = 0.128, respectively). The ROC-curve identified PAPP-A and PI as continuous variables to be significant predictors of preeclampsia (AUC = 0.864, 95% CI = 0.750-0.978, p = 0.000; AUC = 0.762, 95% CI = 0.598-0.925, p = 0.002, respectively). A prediction model for preeclampsia including PAPP-A ≤ 0.52 MoM + PI ≥ 2.52 was found to be significantly associated with preeclampsia (p = 0.027). Conclusion: The present study suggests that the firsttrimester extreme low-PAPP-A and increased Doppler-PI levels have significant predictive capability for preeclampsia.First trimesterPreeclampsia predictionResource limited settings