Purpose: Aim of the study was to investigate serum levels of total carnitine, arginine, asymmetric dimethylarginine (ADMA) and ischemia-modified albumin (IMA) and their combined use for the early detection of preeclampsia. 

Materials and Methods: The study group, which included normal pregnancies, consisted of a total of 44 singleton pregnant women (gestational age: between 6 and 12 weeks), divided into a preeclampsia group (n = 22) and a control group (n = 22). 

Results: When the serum levels of both groups in the 6th and 12th week of gestation were compared with levels between the 21st and 35th week of gestation, total carnitine, ADMA, IMA levels were increased; L-arginine levels were decreased in the preeclampsia group. Using a total carnitine level of <= 3.62 nmol/ml as a cut-off value, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 68, 64, 65 and 64%; using an ADMA level of <= 518.70 ng/ml as a cut-off value, the sensitivity, specificity, PPV and NPV were 82, 32, 55 and 64%; using an L-arginine level of <= 161.23 nmol/ ml as a cut-off value, the sensitivity, specificity, PPV and NPV were 45, 73, 62, 57%; using an IMA level of > 0.82 as a cut-off value, the sensitivity, specificity, PPV and NPV were 45, 77, 64 and 57%, respectively. When all parameters were taken together to predict preeclampsia, the sensitivity, specificity, PPV and NPV were 9, 100, 100 and 52%, respectively. 

Conclusion: Although the sensitivity of ADMA levels was found to be higher in individual measurements, there is still no independent placental ischemia factor which can predict preeclampsia.