FIRST TRIMESTER SCREENING FOR PREECLAMPSIA - A SYSTEMATIC REVIEW.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Preterm preeclampsia (PE) presents a significant risk to maternal and fetal health.
• Current screening methods for PE lack sufficient detection rates, necessitating improved diagnostic tools.
• Early detection of PE in the first trimester is crucial for timely intervention and improved outcomes.

Purpose of the Study:

• To provide a comprehensive overview of emerging first-trimester screening markers for preterm preeclampsia (PE).
• To review and evaluate the performance of various screening algorithms and their validation status for PE detection.
• To identify the most effective screening strategies for early identification of PE.

Main Methods:

• A comprehensive literature review was conducted focusing on first-trimester screening for PE.
• Studies investigating biochemical, biophysical, and ultrasound markers were systematically identified and analyzed.
• Published screening algorithms and their validation data were critically assessed.

Main Results:

• A substantial number of markers were identified, including 160 biochemical, 6 biophysical, and 14 ultrasound markers.
• Twenty-one distinct screening algorithms for PE were published in the reviewed literature.
• The algorithm developed by the Fetal Medicine Foundation (London) demonstrated significant validation and superior performance.

Conclusions:

• The Fetal Medicine Foundation's algorithm significantly outperforms screening based solely on anamnestic risk factors for preterm preeclampsia.
• The identified markers and validated algorithms offer promising advancements in early PE detection.
• Further research and implementation of validated first-trimester screening protocols are recommended to enhance PE management.