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Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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Pre-eclampsia screening in Denmark (PRESIDE): national validation study.

I Riishede1,2, L Rode2,3, L Sperling4,5

  • 1Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
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Summary
This summary is machine-generated.

The Fetal Medicine Foundation (FMF) first-trimester screening algorithm effectively predicts pre-eclampsia in Danish women, outperforming the current risk factor-based strategy. This advanced screening method offers improved detection rates for early-onset pre-eclampsia.

Keywords:
Fetal Medicine Foundationacetylsalicylic acidcompeting-risk modelsfirst trimesterpre-eclampsiascreening

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Area of Science:

  • Maternal-Fetal Medicine
  • Obstetric Ultrasound
  • Pregnancy Screening

Background:

  • Pre-eclampsia poses significant risks to maternal and fetal well-being.
  • Current screening strategies rely on maternal risk factors, offering limited predictive accuracy.
  • First-trimester screening offers a window for early detection and intervention.

Purpose of the Study:

  • To evaluate the predictive performance of the Fetal Medicine Foundation (FMF) first-trimester screening algorithm for pre-eclampsia in a Danish population.
  • To compare the FMF algorithm's screening performance against the existing Danish strategy based on maternal risk factors.
  • To assess the algorithm's efficacy in detecting early-onset and preterm pre-eclampsia.

Main Methods:

  • A prospective study involving 8783 pregnant women across six Danish university hospitals.
  • Data collection included maternal characteristics, mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), PAPP-A, and PlGF.
  • The FMF algorithm was applied retrospectively, blinded to pregnancy outcomes, and compared with the current Danish screening approach.

Main Results:

  • At a 10% screen-positive rate (SPR), the FMF algorithm detected 77.4% of pre-eclampsia cases delivering <34 weeks and 66.8% delivering <37 weeks.
  • The current Danish strategy detected only 25.0% of pre-eclampsia cases delivering <34 weeks and 19.6% delivering <37 weeks at a 3.4% SPR.
  • The FMF algorithm demonstrated significantly higher detection rates for pre-eclampsia at comparable or lower screen-positive rates.

Conclusions:

  • The FMF first-trimester screening algorithm demonstrates robust predictive performance for pre-eclampsia in a Danish cohort, comparable to international findings.
  • The FMF algorithm significantly outperforms the current Danish maternal risk factor-based screening strategy.
  • Implementation of the FMF algorithm in Denmark could enhance early detection and management of pre-eclampsia.