Prediction ofpreeclampsia during extended first-trimester combined prenatal screening

Objective. To evaluate the possibility of using anamnestic data, biophysical indicators, and biochemical markers for combined prenatal screening to predict preeclampsia in the first trimester of pregnancy. Subjects and methods. 511 patients (27 with preeclampsia) with singleton pregnancy at 10-13 weeks gestation were examined. Anamnestic data, systolic blood pressure (SBP), and uterine artery pulsatility index (PI), and trophoblastic proteins were explored. The diagnostic threshold (cut-off point) of the analyzed factors was determined by ROC analysis. Results. The normal range was 0.94-1.10 MoM for SBP, 0.87-1.27 MoM for PI, the median placental growth factor was 1.02 (0.67-1.59) MoM. The authors developed a scoring table to predict preeclampsia, using 9 factors, for each a diagnostic cut-off being calculated in scores. A patient with a sum equal to (-2) points or more (the diagnostic cut-off) belongs to a group at high risk for preeclampsia. Conclusion. The method developed to predict preeclampsia in the first trimester of pregnancy has a useful estimate (AUC = 0.82±0.052; LR+, 3.21; and LR-, 0.29) and can be used in clinical practice.

preeclampsia, combined prenatal screening