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Two-stage screening for preterm preeclampsia at 11-13 weeks' gestation

American Journal of Obstetrics and Gynecology Nov 12, 2018

Wright A, et al. - In this study, researchers studied the possibility of performing first-stage preterm preeclampsia (PE) screening in the whole population by maternal factors alone or in combination of maternal factors, mean arterial pressure (MAP) and uterine artery pulsatility index (UtA-PI) or maternal factors, MAP and serum placental growth factor (PIGF; triple test) and proceeding to second-stage screening by the triple test only for a subgroup of the population selected on the basis of the risk derived from first-stage screening. Data were derived from prospective non-intervention screening for PE at 11+0 – 13+6 weeks’ gestation in 61,174 singleton pregnancies for this study. According to results, if the method of first-stage screening is maternal factors, then measurements of MAP, UtA-PI and PlGF can be reserved for only 70% of the population achieving similar detection rate and screen positive rate as with screening the whole population with the triple test. In the case of first-stage screening by maternal factors, MAP and UtA-PI, then measurement of PlGF can be reserved for only 30% to 40% of the population and if first-stage screening is by maternal factors, MAP and PlGF, measurement of UtA-PI can be reserved for only 20% to 30% of the population. Outcomes indicated that, compared with conducting the test for the entire population, performing two-stage screening and biomarker testing for only part of the population may be of financial benefit.

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