Practical approach to the prevention of preeclampsia: from screening to pharmaceutical intervention

Preeclampsia occurs in 3-8% of the pregnancies and is associated with a high rate of morbi-mortality, both for mothers and the fetus. Screening and prevention of patients at risk are the optimal way to reduce the morbi-mortality of this disease. To set-up a preventive approach to preeclampsia (PE), one has to identify using a screening strategy for the population at risk and propose them an appropriate therapeutic intervention that would bear a favorable benefits/risk ratio. While the classical method only considers epidemiological risk factors to set up preventive measures, several authors have set-up complex multiparameter algorithm to detect a population at risk of PE. The new pyramid of pregnancy care integrates an early clinic allowing the assessment of biophysical and biochemical markers combined with maternal factors. Such an approach can identify pregnancies that are at high risk of PE and reduce its prevalence using low-aspirin regimen initiated as early as possible in the population at risk.