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ORIGINAL ARTICLE
Year : 2018  |  Volume : 35  |  Issue : 3  |  Page : 356-362

First-trimester prediction of preterm labor using disintegrin and metalloprotease 12, uterine artery Doppler, and maternal characteristics


Department of Obstetrics and Gynecology, Shebin Elkom Teaching Hospital, Egyptian Ministry of Health, Shebin Elkom, Egypt

Correspondence Address:
Dr. Ayman Abd El Hakim Abd El Ghany
Menouf, El-Menoufiya Governorate, Menouf City, 7 El\masady Street
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bmfj.bmfj_100_18

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Background A disintegrin and metalloprotease 12 (ADAM12) is a complex placenta-derived protein with proteolytic activity that may serve as a marker of placental dysfunction for the identification of preterm birth. This has benefits of an early intervention and increased antenatal surveillance. In addition, uterine artery Doppler studies are noninvasive measurements of placental vascular flow with increased resistance reflecting impaired trophoblastic invasion. Objectives The objective of this study is to estimate the efficiency of first-trimester maternal serum ADAM12, uterine artery Doppler, and maternal characteristics in the early prediction of preterm birth. Patients and methods This cohort study was conducted on 90 pregnant women in their first trimesters with selection criteria. All patients were investigated for ADAM12 protein level, uterine artery Doppler, and maternal characteristics. They were followed up for screening of preterm birth (before 37 weeks). Results Uterine artery Doppler pulsatility index and maternal serum ADAM12 level either individually or combined are not statistically significant predictors of spontaneous preterm birth. The combination of maternal ADAM12 and BMI with cutoff levels of 162 pg/ml and 32 kg/m2, respectively, was a highly significant effective predictor of preterm birth. Advancing maternal age, increasing parity, increased BMI, and hypertension were maternal characteristics that correlated significantly with preterm birth. Conclusion Uterine artery Doppler pulsatility index and maternal serum ADAM12 level are not statistically significant predictors of spontaneous preterm birth, but ‘combined’ ADAM12 and BMI can do it significantly.


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