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First-Trimester Screening Using a Fetomaternal Calculator Versus Maternal History-Based Screening for the Prevention
Neeru Malik1, Sandhya Jain1, Dakshika Lochan1
1Department of Obstetrics and Gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, IND.
Cureus
|August 12, 2026
Summary
The Fetal Medicine Foundation (FMF) calculator significantly improves preeclampsia (PE) screening accuracy compared to traditional methods. This multi-parametric approach offers a more effective strategy for early detection and management of PE in diverse populations.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Preeclampsia (PE) is a significant cause of maternal and perinatal morbidity in India.
- Traditional screening methods based on medical history often lack sufficient sensitivity for PE detection.
- This study addresses the need for more effective screening strategies in North Indian populations.
Purpose of the Study:
- To evaluate the effectiveness of Fetal Medicine Foundation (FMF) calculator-based screening for preeclampsia.
- To compare the FMF calculator's multi-parametric approach (without biochemical markers) against traditional maternal history-based screening.
- To assess the impact of FMF calculator screening on preterm PE incidence and NICU admissions.
Main Methods:
- A prospective observational study involving 400 pregnant women at 11-13+6 weeks gestation.
- Participants were randomized into two groups: Group A (FMF calculator-based screening) and Group B (maternal history-based screening).
- FMF calculator utilized maternal history, mean arterial pressure (MAP), and uterine artery pulsatility index (UtA-PI). High-risk cases received aspirin prophylaxis.
Main Results:
- Group A demonstrated a significantly lower incidence of preterm PE (4.9%) compared to Group B (12.4%) (p=0.011).
- Total PE incidence was lower in Group A (7.6%) versus Group B (18.3%) (p=0.002).
- The FMF calculator group showed reduced NICU admissions (7.6% vs 15.1%, p=0.025) and better identification of low-risk women who developed PE.
Conclusions:
- First-trimester FMF calculator screening without biochemical markers is superior to history-based checklists for PE detection.
- This protocol offers a viable, resource-efficient screening strategy for low- and middle-income countries.
- Implementing the FMF calculator can lead to improved maternal and perinatal outcomes by enabling earlier PE detection and intervention.