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Stratification of pregnancy care based on risk of preeclampsia derived from biophysical and biochemical markers at 19–24 weeks' gestation

Ultrasound in Obstetrics & Gynecology Aug 02, 2021

Litwinska M, Litwinska E, Astudillo A, et al. - In their prior works, researchers proposed performing assessment of risk for preeclampsia (PE) in all pregnant women at 20 and 36 weeks' gestation and using the 20-week assessment to define subgroups necessitating additional monitoring and reassessment at 28 and 32 weeks. Researchers herein evaluated the potential improvement generated in screening at 19–24 weeks' gestation for PE with delivery at < 28, < 32, < 36 and ≥ 36 weeks' gestation by adding serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) to the combination of maternal demographic characteristics and medical history, uterine artery pulsatility index (UtA-PI) and mean arterial pressure (MAP). They conducted a prospective, non-intervention study of 37,886 singleton pregnancies. Subsequent development of PE was observed in 1,130 of these pregnancies (3.0%), including 160 (0.4%) that delivered at < 36 weeks' gestation. Per findings, the addition of serum PlGF and sFlt-1 to the combination of maternal demographic characteristics and medical history, UtA-PI and MAP led to an improvement in the performance of screening at 19–24 weeks' gestation for PE with delivery at < 28, < 32 and < 36 weeks' gestation. They recorded poor performance of screening for PE at ≥ 36 weeks' gestation irrespective of the method of screening at 19–24 weeks.

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