Preeclampsia Prediction and Prophylaxis in Routine First-trimester Screening Services

JOURNAL TITLE: Donald School Journal of Ultrasound in Obstetrics and Gynecology

Author
1. Tuangsit Wataganara
2. Piengbulan Yapan
3. Amprapha Phaophan
4. Piyatida Thongkloung
5. Panumas Kamkang
6. Chutima Yaiyiam
7. Kantamanee Thuphairo
ISSN
0973-614X
DOI
10.5005/jp-journals-10009-1654
Volume
14
Issue
3
Publishing Year
2020
Pages
8
Author Affiliations
    1. Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok Noi, Bangkok, Thailand
    1. Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok Noi, Bangkok, Thailand
    1. Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok Noi, Bangkok, Thailand
    1. Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok Noi, Bangkok, Thailand
    1. Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Bangkok Noi, Bangkok, Thailand
    1. Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Bangkok Noi, Bangkok, Thailand
    1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok Thailand
  • Article keywords
    Placental growth factor, Preeclampsia, Prenatal screening, Uterine artery Doppler studies

    Abstract

    Prenatal screening confers benefits to the population served by that program. Screening programs that are poorly implemented can also be harmful. This article proposes the practical means to establish a routine clinical service of first-trimester prediction for preterm preeclampsia. A combination of maternal characteristics, mean arterial pressure, uterine artery Doppler, and placental growth factor can identify the majority of preterm (<37 weeks of gestation) preeclampsia with reasonably low false-positive rate. A single visit to an integrated clinic at 11–13 weeks’ gestation also allows for an assessment of the risks for a wider range of pregnancy complications, including common fetal aneuploidies and early-onset fetal growth restriction. Certification and audit of ultrasound operators and laboratories is important to assure the quality of the prenatal screening service. In the context of preeclampsia, the primary aim of such clinic is to identify those that would potentially benefit from prophylactic intervention with aspirin to improve placentation.

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