Implementation of routine first-trimester combined screening for preeclampsia based on the Gaussian algorithm: A...

Area of Science:

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

Background:

• Preeclampsia (PE) is a significant cause of maternal and neonatal morbidity.
• Early detection and intervention are crucial for improving outcomes.
• First-trimester screening for PE has shown promise in clinical trials.

Purpose of the Study:

• To evaluate the clinical effectiveness of routine first-trimester preeclampsia screening.
• To assess the impact of the screening program on preterm PE incidence.
• To determine the effect on maternal intensive care unit (ICU) admissions.

Main Methods:

• A comparative study involving a reference group (pre-implementation) and a study group (post-implementation).
• PE risk assessment using the Gaussian algorithm (maternal characteristics, mean arterial blood pressure, uterine artery pulsatility index, PAPP-A) between 11-14 weeks gestation.
• Intervention: daily low-dose aspirin (150 mg) for women with PE risk ≥1/137 until 36 weeks gestation.

Main Results:

• A significant reduction in preterm PE incidence was observed in the study group (0.63%) compared to the reference group (1.14%).
• Maternal ICU admissions were significantly lower in the study group (0.81%) versus the reference group (1.40%).
• The screening and intervention protocol demonstrated a statistically significant protective effect.

Conclusions:

• Routine first-trimester preeclampsia screening is feasible and effective in a public healthcare setting.
• Implementation led to a significant decrease in preterm PE and maternal ICU admissions.
• This approach offers a valuable strategy for improving maternal and fetal outcomes.