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First-Trimester Combined Multimarker Prospective Study for the Detection of Pregnancies at a High Risk of Developing
Meriem Guizani1, Joseph Valsamis, Vivien Dutemeyer
1Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
Insights
The Fetal Medicine Foundation (FMF) algorithm effectively screens for preterm preeclampsia (PE) in the first trimester. This prospective study demonstrates its utility in predicting early-onset PE.
Area of Science:
- Maternal-fetal medicine
- Obstetrics and Gynecology
- Pregnancy diagnostics
Background:
- Preeclampsia (PE) is a significant complication of pregnancy.
- Early prediction of PE is crucial for timely intervention and improved outcomes.
- First-trimester screening aims to identify pregnancies at high risk for PE.
Purpose of the Study:
- To prospectively evaluate the Fetal Medicine Foundation (FMF) algorithm for preeclampsia prediction.
- To assess the algorithm's performance at 11-13 weeks' gestation.
- To determine the detection rate (DR) and false-positive rate (FPR) for preterm and term PE.
Main Methods:
- Prospective, single-center screening study of singleton pregnancies.
- Utilized the FMF algorithm incorporating maternal characteristics and biomarkers.
- Estimated DR for a 10% FPR for preterm (<37 weeks) and term (≥37 weeks) PE.
Main Results:
- 3,239 pregnancies were analyzed; 1.1% developed preterm PE and 1.4% developed term PE.
- Combined screening (maternal factors, MAP, UtAPI, PlGF) achieved an 80.6% DR for preterm PE at a 10% FPR.
- The DR for term PE was 31.8% at a 10% FPR.
Conclusions:
- The FMF algorithm demonstrates effective first-trimester screening for preterm preeclampsia.
- The findings support the use of the FMF algorithm for early PE risk assessment.
- Further validation in diverse populations may be warranted.
Objective:
To evaluate the Fetal Medicine Foundation (FMF) algorithm prospectively at 11-13 weeks' gestation in the prediction of preeclampsia (PE).
Methods:
Single-center prospective screening study for PE of singleton pregnancies at 11-13 weeks. The FMF algorithm takes into account maternal characteristics and biomarkers. Detection rate (DR) for a 10% false-positive rate (FPR) for delivery with preterm and term PE was estimated.
Results:
Between January 2011 and December 2013, of 3,239 patients available for final analysis, 36 (1.1%) subsequently developed preterm and 44 (1.4%) term PE. In combined screening by maternal factors, mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, the DR was 80.6% (95% CI 64.0-91.8) for PE at <37 weeks and 31.8% (95% CI 18.6-47.6) for PE at ≥37 weeks, at a 10% FPR.
Conclusion:
Our data suggest that the FMF algorithm provides effective first-trimester screening for preterm PE.
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