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Mouse Model of Surgical Uterine Injury and Subsequent Pregnancy Outcomes

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First trimester screening cannot predict adverse outcomes yet.

Torre L Halscott¹, Patrick S Ramsey, Uma M Reddy

¹Division of Maternal-Fetal Medicine, MedStar Washington Hospital Center, MedStar Georgetown University Hospital, Washington, DC, USA.

Prenatal Diagnosis

|May 24, 2014

Summary

This summary is machine-generated.

First trimester screening for aneuploidy is common, but current methods lack sufficient predictive value for adverse pregnancy outcomes like preeclampsia or preterm birth. Effective interventions are needed to make first trimester screening for these conditions clinically impactful.

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Area of Science:

Maternal-Fetal Medicine
Prenatal Diagnostics
Obstetrics

Background:

First trimester screening is standard for aneuploidy detection.
Identifying high-risk pregnancies early could improve outcomes.
Effective interventions are crucial for screening utility.

Purpose of the Study:

To evaluate the clinical impact of first trimester screening for adverse pregnancy outcomes.
To assess the predictive value of current screening methods for preeclampsia, fetal growth restriction, preterm birth, and stillbirth.
To highlight the need for improved screening algorithms and understanding of pathophysiology.

Main Methods:

Review of current evidence on first trimester screening markers (serum and ultrasound).
Analysis of predictive values for preeclampsia, fetal growth restriction, preterm birth, and stillbirth.
Assessment of available interventions for identified high-risk pregnancies.

Main Results:

First trimester screening lacks sufficient positive predictive value for major adverse pregnancy outcomes.
Interventions for fetal growth restriction and stillbirth are limited to delivery.
Low-dose aspirin shows benefit for preeclampsia in specific subgroups.
First trimester markers do not significantly improve preterm birth prediction beyond demographic factors.

Conclusions:

Current first trimester screening methods are inadequate for predicting preeclampsia, fetal growth restriction, preterm birth, or stillbirth.
Development of effective screening requires understanding the heterogeneous nature and pathophysiology of these conditions.
Future research should focus on improving screening algorithms and identifying effective early interventions.