Placental dysfunction screening and perinatal loss

Liu, Becky; Frick, Alexander; Bhide, A.; Thilaganathan, B.

doi:10.1111/1471-0528.17197

Cited by 1 publication

(2 citation statements)

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“…Effective early pregnancy screening for PE using the Fetal Medicine Foundation (FMF) algorithm, 12 with targeted interventions in the high‐risk group, has been shown to reduce the incidence of preterm PE and associated pregnancy adverse outcomes 6,13–16 . However, there is a paucity of data on the clinical role for mid‐gestation UtAD assessment in a population that has already undergone such early pregnancy screening.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11] Effective early pregnancy screening for PE using the Fetal Medicine Foundation (FMF) algorithm, 12 with targeted interventions in the high-risk group, has been shown to reduce the incidence of preterm PE and associated pregnancy adverse outcomes. 6,[13][14][15][16] However, there is a paucity of data on the clinical role for mid-gestation UtAD assessment in a population that has already undergone such early pregnancy screening. The aim of this study is to evaluate whether midgestational UtAD assessment significantly further modifies the risk of placentally mediated adverse pregnancy outcomes in a population who has undergone routine first-trimester multi-parameter combined pre-eclampsia screening.…”

Section: Introductionmentioning

confidence: 99%

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Is mid‐gestational uterine artery Doppler still useful in a setting with routine first‐trimester pre‐eclampsia screening? A cohort study

Meroni

Mascherpa

Minopoli

et al. 2023

BJOG

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Objective To evaluate whether routine mid‐gestational uterine artery Doppler (UtAD) modifies the risk for preterm pre‐eclampsia after first‐trimester combined pre‐eclampsia screening. Design Retrospective cohort study. Setting London Tertiary Hospital. Population A cohort of 7793 women with singleton pregnancies, first‐trimester pre‐eclampsia screening using the Fetal Medicine Foundation (FMF) algorithm and UtAD pulsatility index (PI) assessment at the mid‐gestation ultrasound. Methods Pregnancies were divided into four groups: high risk in both trimesters (H1H2), high risk in the first but not in the second trimester (H1L2), low risk in the first but high risk in the second trimester (L1H2) and low risk in both trimesters (L1L2). Main outcome measures Small for gestational age (SGA), hypertensive disorders of pregnancy (HDP) and stillbirth. Results In this cohort, 600 (7.7%) and 620 (7.9%) women were designated as being at high risk in the first and second trimesters, respectively. Preterm pre‐eclampsia was more prevalent in the H1L2 group (4.5%) than in women considered at low risk in the first trimester (0.4%, p < 0.0001). The prevalence of preterm pre‐eclampsia in the L1H2 group (3.3%) was significantly lower than that in women considered at high risk in the first trimester (7.0%, p = 0.0076), and was higher than that observed in the L1L2 group (0.2%, p < 0.0001). The prevalence of SGA and term HDP followed similar trends. Conclusions Pre‐eclampsia risk after first‐trimester FMF pre‐eclampsia screening may be stratified through mid‐gestational routine UtAD assessment. Pregnancy care should not be de‐escalated for low mid‐gestational UtAD resistance in women classified as being at high risk in the first trimester. The escalation of care may be justified in women at low risk but with high mid‐gestational UtAD resistance.

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Section: Introductionmentioning

confidence: 99%