Fetal compromise and the changes of utero-placental blood flow lead to utero-placental insufficiency, respectively to adverse pregnancy outcome which will be manifested by pregnancy induced hypertension, preeclampsia, intrauterine growth retardation, small for gestation age fetus, etc. One of the proteins that gives data for the above mentioned changes is Inhibin A, which synthesizes and excretes during pregnancy from placental  syncytiotrophoblast and regulates some hormones in local placental regulatory axis that are in relation to endometrial decidualisation, embryonal implantion, proliferation and differentiation of trophoblast, placental growth and function, which are all important for fetal growth. Objective of this research is to do a prenatal screening and a correlation of serum Inhibin A and the doppler of both uterine arteries, in the second trimester of pregnancy, as possible predictors for early diagnosis of eventual risky pregnancy. Method This cohort study is realized in a Special Hospital for Gynecology and Obstetrics “Mother Theresa”, Skopje, during the period from November 2019 to June 2022 and includes 773 pregnant women, between 18-22.6 gestational weeks, followed up and monitored till delivery. There are followed up the value of serum Inhibin A, fetal biometry, and PI and RI of both uterine arteries. Also the gestational week and bodily measures of the fetus were followed up in delivery. Statistical processing: It was conducted a statistical analysis of maternal characteristics in examined and control group, there were determined the variables which significantly associate with adverse pregnancy outcome, validity of diagnostic tests for adverse pregnancy outcome and in the end were followed performances of the test. Results: From 773 respondents, 599 that is 77.7% had no adverse pregnancy outcome and made up the control group, while in 174 that is 22.3% of pregnant women the pregnancy outcome was adverse and they made up the examined group. From examined group, 38 (7.13%) had preeclampsia, 32 (8.26%) had pregnancy induced hypertension, 5 (2.97%) had fetus small for gestational age, and 13 (7.43%) had intrauterine growth retardation. Discussion More common findings of high values of Inhibin A in pregnant women with adverse outcome, versus those with no adverse outcome, statistically were confirmed as significant. Conclusion Inhibin A value as a single marker for adverse pregnancy outcome was find as the best predictor, while it’s combination with the flows of both uterine arteries during second trimester of pregnancy, as a combined model, represented the best differentiation ability test for pregnant women with adverse and not adverse pregnancy outcome.

Pranvera Izairi, working in SHGO “Mother Theresa”, Skopje, Republic of North Macedonia