Clinical implementation of pre-eclampsia screening in the first trimester of pregnancy
| Autor: | Lucia Pasquini, Silvia Conticini, Adalgisa Cordisco, Enrico Periti, Nicole Antoniolli, Giulia Vannucci, Giulia Masini, Virginia Lozza |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Population Gestational Age 030204 cardiovascular system & hematology Risk Assessment Sensitivity and Specificity Preeclampsia 03 medical and health sciences 0302 clinical medicine Pre-Eclampsia Pregnancy Internal Medicine Humans Mass Screening Medicine education Retrospective Studies education.field_of_study 030219 obstetrics & reproductive medicine Eclampsia business.industry Obstetrics Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Gestational age Retrospective cohort study medicine.disease Pregnancy Trimester First Italy Gestation Female False positive rate business Algorithms |
| Zdroj: | Pregnancy Hypertension. 25:34-38 |
| ISSN: | 2210-7789 |
| DOI: | 10.1016/j.preghy.2021.05.010 |
| Popis: | Early identification of preeclampia in the first trimester of pregnancy represents one of the major challenges of modern fetal medicine. The primary aim of our study was to evaluate the effectiveness of implementation of preeclampsia screening in Tuscany, Italy. The secondary aim was to evaluate pregnancy/neonatal outcome in the positive screening group compared with the negative screening group.Retrospective study including singleton pregnancies undergoing screening for preeclampsia. The screening test was a multiparametric algorithm based on maternal history, biochemical and biophysical parameters (Fetal Medicine Foundation algorithm).The overall performance of the test was calculated, in terms of sensitivity, specificity, positive and negative predictive value and in relation to gestational age at onset (primary aim). Pregnancy and neonatal outcomes were then compared between the positive and negative population at preeclampsia screening test (secondary aim).Of the 5719 patients enrolled, 4797 were included in the analysis. The sensitivity for early onset of preeclampsia (≤34 weeks) was 0.75 (CI:0.41-0.93) and specificity 0.93 (CI:0.92-0.94) for a false positive rate of 7%. The population that tested positive for preeclampsia screening showed a higher incidence of deliveries at lower gestational ages (p 0.001), preeclampsia onset despite prophylaxis with aspirin (p 0.001), emergency caesarean section (p 0.001), low fetal birth weight (p 0.001) and neonatal admission in intensive care unit (p 0.001).Our data confirm the validity of first trimester screening test in identifying a category of patients at greatest risk for preeclampsia even in the presence of a post-test pharmacological prophylaxis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect