Maternal serum homocysteine and uterine artery Doppler as predictors of preeclampsia and poor placentation

The aim of this study was to evaluate the role of maternal serum total Homocysteine (tHcy) and uterine artery (Ut-A) Doppler as predictors of preeclampsia (PE), intrauterine growth restriction (IUGR), and other complications related to poor placentation. A prospective cohort study was conducted on 500 women with spontaneous pregnancies. tHcy was measured at 15-19 weeks, and then, Ut-A Doppler was performed at 18-22 weeks of pregnancy. 453 pregnant women completed the follow-up of the study. The tHcy and Ut-A resistance index were significantly higher in women who developed PE, IUGR, and other complications when compared to controls (tHcy: 7.033 +/- 2.744, 6.321 +/- 3.645, and 6.602 +/- 2.469 vs 4.701 +/- 2.082 mu mol/L, respectively, p value < 0.001 and Ut-A resistance index: 0.587 +/- 0.072, 0.587 +/- 0.053, and 0.597 +/- 0.069 vs 0.524 +/- 0.025, respectively, p value < 0.001). The use of both tHcy assessment and Ut-A Doppler improved the sensitivity of prediction of PE relative to the use of each one alone (85.2 relative to 73.33 and 60%, respectively). The use of elevated homocysteine and uterine artery Doppler screening are valuable in prediction of preeclampsia, IUGR, and poor placentation disorders.