PP114. First trimester multi-parameter prediction of pre-eclampsia.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Diagnostic Screening

Background:

• Pre-eclampsia (PE) affects 3-5% of pregnancies, causing significant maternal and perinatal morbidity and mortality.
• Current screening tests for PE lack consistent sensitivity and predictive value, with no single test widely adopted.
• Combining multiple tests may enhance the predictive value for PE.

Purpose of the Study:

• To evaluate a combined screening approach for pre-eclampsia (PE) in the first trimester.
• The study focused on integrating maternal risk factors, mean arterial pressure (MAP), and uterine artery Doppler.
• The goal was to improve the prediction of hypertensive disorders in pregnancy.

Main Methods:

• A prospective study of 487 singleton pregnancies at 11-14 weeks gestation in a tertiary Brazilian hospital.
• Data collected included maternal history, BMI, MAP, and uterine artery pulsatility index (PI).
• Logistic regression analysis was used to develop predictive algorithms for hypertensive disorders.

Main Results:

• Key predictors identified were nulliparity and personal/family history of PE.
• Mean arterial pressure (MAP) was significantly higher in women who developed PE (86 vs. 78 mmHg).
• Uterine artery PI was also significantly higher in the PE group (50.3%±31.7% vs. 37.4%±30.0%).

Conclusions:

• A combined model using maternal risk factors, MAP, and uterine artery Doppler achieved a 78% detection rate for early PE with a 10% false-positive rate.
• This multimodal approach surpasses traditional methods based solely on demographics and history, which identify only ~60% of early PE cases.
• The findings suggest a more effective strategy for early pre-eclampsia screening in the first trimester.