Association of Serum Soluble Endoglin Levels with Adverse Foetomaternal Outcome in Preeclampsia and Eclampsia

Abstract

Background: Serum Endoglin has also previously shown to be elevated in woman with established preeclampsia especially in those presenting with preterm labour and foetal growth retardation. Objectives: To evaluate association of serum soluble Endoglin with adverse foeto-maternal outcome in woman with hypertensive disorders of pregnancy. Materials and Methods: A prospective case control study carried out from 2013 to 2014 at department of Obstetrics and Gynaecology. Ethical clearance was obtained from institutional ethics committee No.ECR/262/Inst/UP/2013 from King Georges Medical University, Lucknow. After informed consent, total 90 pregnant women from gestational age 20-40 weeks were enrolled after randomization. 30 women of preeclampsia and 30 of antepartum eclampsia served as cases where as 30 normotensive pregnant women served as controls. Preeclampsia was defined as per NHBPEP2000 working group. Estimation of serum soluble Endoglin level was done by Enzyme linked immunosorbent assay using ELISA kit. Results: Serum Endoglin levels were found higher in preeclampsia and eclampsia group (p<0.001) in comparison to controls. The women who had complication in terms of postpartum haemorrhage, cerebrovascular accident during the study had maternal serum Endoglin levels 12.48 ng/ml, and 16.08 ng/ml, respectively in preeclampsia group and 15.88 ng/ml, 16.76 ng/ml respectively in eclampsia group. 4 women expired, all were from eclampsia group mean serum Endoglin level of these women was 14.18±2.4. Serum Endoglin levels increased with low birth weight in preeclampsia and eclampsia. 12 neonates in preeclampsia and 17 neonates in eclampsia, required admission to NICU, in whom the maternal serum Endoglin level was 14.67±1.77, 15.68±1.48 respectively, which was higher than those neonates who did not required admission & difference was statistically significant (p<0.001). Neonates who died had high maternal S. Endoglin level (15.77±0.44 and 16.23±1.30) as compared to alive foetuses (12.35±2.49, 14.30±1.86 respectively). Conclusion: Serum soluble Endoglin level might predict adverse foetomaternal outcome, but larger studies should be carried out to confirm this association.