First- and second-trimester screening for preeclampsia and intrauterine growth restriction

Preeclampsia and intrauterine growth restriction are major contributors to perinatal mortality and morbidity. Accurate prediction is important for identifying those women who require more intensive monitoring, permitting earlier recognition and intervention, and allowing targeting of potential preventive measures to those at risk. Although different measures of placental dysfunction have been associated with increased risk adverse pregnancy outcomes, the ability of any single one to accurately predict these outcomes is poor. Attempts to use predictive models combining analytes and measurements of placental structure and blood flow have so far produced mixed results. The use of first- and second-trimester biochemical markers in combination with uterine artery Doppler screening shows promise as potential screening tools. Large prospective studies are needed to further evaluate the choice of parameters and strategies of combination to achieve the best predictive models.