Taiwanese new direction in prediction of early pregnancy preeclampsia

Taiwan J Obstet Gynecol. 2021 Jan;60(1):66-69. doi: 10.1016/j.tjog.2020.11.009.

Abstract

Objective: First trimester screening is essential to preeclampsia (PE) prevention. Fetal Medicine Foundation (FMF) model combined maternal characteristics with mean arterial pressure (MAP), uterine artery pulsatility index (UtAPI) and placental growth factor (PlGF) to estimate risk. High detection rate (DR) was observed in Asia. The study aims to evaluate performance of screening in Taiwan.

Materials and methods: This was a prospective and non-interventional study between January, 2017 and June, 2018. Data was collected from 700 pregnant women at 11+0-13+6 gestational week. Maternal characteristics were recorded. MAP, UtAPI and PlGF were measured and converted into Multiple of the Median (MoM). Patient-specific risks were calculated with FMF model. Performance of screening was examined by ROC curve and DR.

Results: 25 women (3.57%) contracted PE, including 8 with preterm PE (1.14%). In preterm PE, mean MoM of MAP and UtAPI were higher (1.096 vs 1.000; 1.084 vs 1.035). Mean MoM of PlGF was lower (0.927 vs 1.031). DR in preterm PE achieved 12.5%, 50.0%, 50.0% and 62.5% at false-positive rate (FPR) of 5%, 10%, 15% and 20%.

Conclusion: FMF model showed high DR for PE in Taiwan. Integration of PE and Down screening could set up a one-step workflow.

Keywords: First trimester; Mean arterial pressure; Placental growth factor; Preeclampsia; Uterine artery pulsatility index.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Arterial Pressure
  • Biomarkers / analysis
  • Female
  • Gestational Age
  • Humans
  • Incidence
  • Placenta Growth Factor / blood
  • Pre-Eclampsia / diagnosis*
  • Pre-Eclampsia / epidemiology
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Trimester, First / physiology
  • Premature Birth / diagnosis*
  • Premature Birth / epidemiology
  • Prenatal Diagnosis / methods*
  • Prospective Studies
  • Pulsatile Flow
  • ROC Curve
  • Risk Assessment / methods
  • Taiwan / epidemiology
  • Uterine Artery / physiopathology

Substances

  • Biomarkers
  • PGF protein, human
  • Placenta Growth Factor