To assess how effective macrophage stimulating protein α-chain (MSP-α) combined with uterine artery Doppler is in predicting preeclampsia in singleton pregnancies during 11-13⁺⁶ weeks of gestation. This prospective observational study included singleton pregnant women who attended antenatal care at King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University between December 2021 and April 2023, during 11-13⁺⁶ weeks of gestation. Serum MSP-α levels were collected and uterine artery Doppler ultrasound was performed. Pregnancy outcomes were recorded, and the predictive values of these tests were determined to predict preeclampsia. A total of 365 patients, with 21 cases of preeclampsia (5.8%), were analyzed. Serum MSP-α levels were higher in pregnant women who developed preeclampsia than those who did not (899.7 ± 550.1 ng/ml vs 642.5 ± 466.1 ng/ml, p = 0.016). The mean pulsatility index of the uterine artery and the presence of diastolic notching were not significantly different between the groups. As a cut-off value for predicting preeclampsia, using serum MSP-α levels higher than 1.0 multiple of median for gestational age, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 71.4%, 50.3%, 8.1%, and 96.7%, respectively. Additionally, when abnormal serum MSP-α levels were combined with a uterine artery Doppler pulsatility index above the 95th percentile and bilateral notching as predictive values for preeclampsia, the sensitivity was 85.7%, specificity was 18.3%, PPV was 6.0%, and NPV was 95.5%. Serum MSP-α alone at 11-13⁺⁶ weeks of gestation was effective in predicting preeclampsia. However, the use of serum MSP-α in combination with uterine artery Doppler increased sensitivity but reduced specificity for the prediction of preeclampsia.

Keywords: Predictive value; Preeclampsia; Serum MSP-α levels; Uterine artery Doppler.

© 2024. The Author(s).

为了评估巨噬细胞刺激蛋白α链（MSP-α）与子宫动脉多普勒联合预测单胎妊娠11至13周6天期间子痫前期的有效性。这项前瞻性观察研究包括了2021年12月至2023年4月间在泰国朱拉隆功大学医学部妇产科朱拉隆功纪念医院进行产前检查的单胎孕妇。在这项研究中，收集了孕妇的血清MSP-α水平，并进行了子宫动脉多普勒超声检查。记录了妊娠结局，并确定了这些检查预测子痫前期的价值。共有365名患者参与分析，其中21例（5.8%）患有子痫前期。在发生子痫前期的孕妇中，血清MSP-α水平高于未发生子痫前期的孕妇（899.7 ± 550.1 ng/ml vs 642.5 ± 466.1 ng/ml, p = 0.016）。子宫动脉的脉动指数和舒张期切迹的存在在两组之间没有显著差异。使用血清MSP-α水平高于同胎龄中位数1.0倍作为预测子痫前期的临界值，其敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为71.4%、50.3%、8.1% 和 96.7%。此外，当异常血清MSP-α水平与子宫动脉多普勒脉动指数高于第95百分位数及双侧切迹作为预测子痫前期的指标结合使用时，敏感性为85.7%，特异性为18.3%，阳性预测值为6.0%，阴性预测值为95.5%。在妊娠11至13周6天期间单独使用血清MSP-α可以有效预测子痫前期。然而，联合使用血清MSP-α和子宫动脉多普勒提高了敏感性但降低了预测子痫前期的特异性。

关键词： 预测价值；子痫前期；血清MSP-α水平；子宫动脉多普勒。