PAPPA and preeclampsia: In 2009, Akolekar et al. combined PAPP-A with inhibin A, activin A, mean arterial pressure, PP-13, soluble endoglin (sEng), pentraxin, Doppler pulsatility index (PI), placental growth factor (PIGF), and P selection, in a 33,602 patients study, resulting in 61%, 79%, and 91% detection rates for late, intermediate, and early onset preeclampsia, respectively [29], while in 2010, Wortelboer et al. tested PAPP-A with PIGF, a disintegrin and metalloprotease 12 (ADAM 12), and disintegrin and beta hCG and reported only a 44% preeclampsia prediction rate with a 5% false rate (Table 1) [34].