Quality assessment of first-trimester screening for preterm pre-eclampsia.
first trimester
pre-eclampsia
pregnancy
preterm birth
quality assessment
screening
Journal
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
revised:
03
05
2022
received:
28
03
2022
accepted:
17
05
2022
pubmed:
29
5
2022
medline:
6
12
2022
entrez:
28
5
2022
Statut:
ppublish
Résumé
To assess the performance and impact of first-trimester preterm pre-eclampsia screening in a single center. This was a single-center study of women with a singleton pregnancy who were screened prospectively for preterm pre-eclampsia (i.e. delivery before 37 weeks' gestation) using maternal characteristics, mean arterial pressure (MAP), uterine artery Doppler pulsatility index, maternal serum pregnancy-associated plasma protein-A and placental growth factor. The individual risk for preterm pre-eclampsia was estimated from a published model, and those with a risk above 1 in 200 were recommended to take 150 mg soluble aspirin per day until 34 weeks. Information on the incidence of pre-eclampsia was obtained from the hospital register of adverse pregnancy outcomes. Screening performance indicators, including detection and false-positive rates, were estimated from the distribution of risks. Screening impact was estimated by dividing the observed prevalence by the expected prevalence, which was derived from the distribution of risks. The distributions of MAP, uterine artery Doppler pulsatility index and serum markers were consistent with the risk model parameters. The estimated detection and false-positive rates were 79.7% and 16.2%, respectively. There were six cases of preterm pre-eclampsia, four of which occurred in women with a positive screening result. The prevalence was 62% of that expected, but the 95% CI of 23-140% indicated that the study was underpowered to assess the impact. This study demonstrates that the performance of preterm pre-eclampsia screening can be estimated in a single center with fewer than 2000 women screened. However, in order to assess the impact of screening on the prevalence of the condition, a much larger cohort is needed. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
Substances chimiques
Biomarkers
0
Placenta Growth Factor
144589-93-5
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
746-750Informations de copyright
© 2022 International Society of Ultrasound in Obstetrics and Gynecology.
Références
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