IMPACT OF THE FIRST TRIMESTER PREECLAMPSIA SCREENING TEST ON THE OUTCOME OF PREGNANCY BETWEEN THE PATIENTS WITH OR...

Hypertensive disorders are one of the leading causes of maternal and perinatal morbidity and mortality worldwide. It is responsible for around 16% of maternal deaths globally, in 2023 this was the equivalent to around 42 000 deaths. Pre-eclampsia is a hypertensive disorder that affects 3-8% of women who give birth worldwide.

To assess the effectiveness of the first-trimester preeclampsia screening test on Caucasian population and define the impact of conception method on the risk of preeclampsia.

A prospective observational study was conducted at the Zurab Sabakhtarashvili Reproductive Clinic (ZSRC) on the pregnant women from 2021 (January)-2025 (November). All of the participants of the study underwent preeclampsia (PE) first-semester screening test provided by FMF (Fetal Medicine Foundation). Additionally, 8092 deliveries were investigated from Ghudushauri National Center (GNC) (2020-2024 years). Patients who were common for ZSRC and GNC were excluded from study, thus only the patients from GNC who did not underwent first trimester screening of PE were selected. 537 pregnant women, who were conceived with artificial reproductive technology (In vitro fertilization and ovarian stimulation) were chosen as group l. 407 woman who had a spontaneous pregnancy were chosen as a control group (group II). Logistic regression was used to exclude confounding factors.

In 01.01.2021 - 31.11.2025, 988 preeclampsia screening tests were performed at ZSRC. In 520 cases were confirmed a high risk (52.63%). 352 pregnant women who underwent first-trimester screening test were investigated.

133 patient - fertile (37,8%), 219 patient - infertile (62,2%), 199 - low risk of PE (56,5%), 153 - high risk of PE (43,5%), 23 - case of PE (6,5%). No maternal or fetal death recorded. GNC provided 8092 deliveries of unscreened pregnant women between 2020-2024 years. 931 cases of PE were recorded (11,5%). In 862 cases PE had complications (maternal and fetal death and s.o.) For another direction of the study was created group 1 (women who were conceived with assisted reproductive technology) and it was separated into three subgroups. Subgroup 1 - method of conception in vitro fertilization (IVF) and frozen embryo transfer (FET) (240 women). Subgroup 2 - method of conception in vitro fertilization (IVF) and fresh embryo transfer (ET) (149 women). Subgroup 3 - method of conception - ovulation drugs (OVD) (148 women). For control group (group 2) were selected women with spontaneous pregnancy (407 women). The difference in subgroup 1 and subgroup 2 (IVF and FET vs IVF and ET) was not significant (p value=0.47). The difference between group 1 and group 2 (Assisted reproductive technology vs spontaneous pregnancy) was significant (p value=0.002).

First trimester screening of PE is very useful for further management of pregnant women. According to the results of our study, we conclude that, first trimester screening of PE is highly effective way to prevent development of PE in the third trimester. Frozen embryo transfer regimen does not make a difference for risk of preeclampsia, but assisted reproductive technology does make a difference.