Reviewing Accuracy of First Trimester Screening for Preeclampsia Using Maternal Factors and Biomarkers

Malone, Sarah L; Yahya, Rani Haj; Kane, Stefan C.

doi:10.2147/ijwh.s283239

Cited by 12 publications

(6 citation statements)

References 79 publications

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“…►Table 2 shows the relationship between LDA utilization and risk factors for preeclampsia. Patients ages 35 We found no statistically significant differences in pregnancy outcomes based on self-reported aspirin use (►Table 3).…”

Section: Follow-upmentioning

confidence: 72%

“…1,2,19 Research suggests that the use of biomarkers improves preeclampsia screening performance. 35 O'Gorman et al showed that the detection rate using ACOG recommendation versus the Fetal Medicine Foundation algorithm, which incorporates both biophysical and biochemical measurements to maternal risk factors, was, respectively, 94 versus 100% for preeclampsia at less than 32 weeks, 90 versus 75% for less than 37 weeks, and 89 versus 43% for 37 weeks or greater, with a false positive rate of 64.2 versus 10%. 36 Another limitation of our study is the assessment of LDA utilization during the anatomy ultrasound and not in later gestations.…”

Section: Strength and Weaknessmentioning

confidence: 99%

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Feasibility of Universal Screening for Preeclampsia Risk and Aspirin Recommendation in the Ultrasound Unit

Pimentel,

Larrea,

Renaud

et al. 2023

Am J Perinatol

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Objective To evaluate the feasibility and impact of using the first-trimester ultrasound visit to identify and counsel women at increased risk of preeclampsia about the benefits of low-dose aspirin (LDA) for preventing preeclampsia. We also assessed patient-reported utilization of LDA, perceived risk for preeclampsia, and clinical outcomes. Study Design Women presenting for routine first-trimester nuchal-translucency (NT) ultrasounds were screened for clinical preeclampsia risks using a self-administered risk assessment. Women at moderate or high risk for preeclampsia were counseled to take LDA, if not already taking it. LDA utilization and perceived risk for preeclampsia were assessed during the second-trimester ultrasound. Factors associated with LDA utilization were analyzed. Pregnancy outcomes were compared between those who used LDA and those who did not. Results Slightly more than 20% of patients (765/3,669) screened at increased risk for developing preeclampsia. Of those, 67.8% (519/765) had not received LDA recommendations from their referring obstetrician and 97 had not been taking LDA despite being advised to do so. Combined, 94.6% (583/616) of these patients eligible to start LDA prophylaxis received the indicated counseling during the ultrasound visit. A total of 61.4% (358/583) of women completed the follow-up form and of those 77.9% (279/358) reported taking LDA. Screening at increased risk for preeclampsia and perception of increased risk were positively associated with LDA utilization, whereas concerns for LDA safety were negatively associated with use. African American/Black patients and Medicaid recipients were less likely to use LDA. Pregnancy outcomes were similar between those who used LDA and those who did not. Conclusion Assessing preeclampsia risk and counseling patients about LDA at the time of the NT ultrasound are feasible in the ultrasound unit and led to good LDA utilization among women at increased risk for preeclampsia. This intervention may standardize patient care and help close the disparity in maternal health. Key Points

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Section: Follow-upmentioning

confidence: 72%

Section: Strength and Weaknessmentioning

confidence: 99%

Feasibility of Universal Screening for Preeclampsia Risk and Aspirin Recommendation in the Ultrasound Unit

Pimentel,

Larrea,

Renaud

et al. 2023

Am J Perinatol

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“…A huge effort has been put into researching predictors of these www.nature.com/scientificreports/ conditions, yielding some promising but preliminary results. Biomarkers in the maternal bloodstream have been investigated extensively and an association has been found between certain biomarkers and the development of preeclampsia, impaired fetal growth and stillbirth [16][17][18] . Recently, placental microRNAs coding for genes related to angiogenesis, growth, and immunomodulation have been found to be measurable in maternal blood lending promise to yet another potential source of early detection of placenta-related pathology 19,20 .…”

Section: Discussionmentioning

confidence: 99%

Multi-centre deep learning for placenta segmentation in obstetric ultrasound with multi-observer and cross-country generalization

Andreasen

Feragen

Christensen

et al. 2023

Sci Rep

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The placenta is crucial to fetal well-being and it plays a significant role in the pathogenesis of hypertensive pregnancy disorders. Moreover, a timely diagnosis of placenta previa may save lives. Ultrasound is the primary imaging modality in pregnancy, but high-quality imaging depends on the access to equipment and staff, which is not possible in all settings. Convolutional neural networks may help standardize the acquisition of images for fetal diagnostics. Our aim was to develop a deep learning based model for classification and segmentation of the placenta in ultrasound images. We trained a model based on manual annotations of 7,500 ultrasound images to identify and segment the placenta. The model's performance was compared to annotations made by 25 clinicians (experts, trainees, midwives). The overall image classification accuracy was 81%. The average intersection over union score (IoU) reached 0.78. The model’s accuracy was lower than experts’ and trainees’, but it outperformed all clinicians at delineating the placenta, IoU = 0.75 vs 0.69, 0.66, 0.59. The model was cross validated on 100 2nd trimester images from Barcelona, yielding an accuracy of 76%, IoU 0.68. In conclusion, we developed a model for automatic classification and segmentation of the placenta with consistent performance across different patient populations. It may be used for automated detection of placenta previa and enable future deep learning research in placental dysfunction.

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“…Disease development is a protracted process rather than something that immediately happens, one with potentially significant morbidity and even mortality to both mother and baby. 19 Identifying those at high risk of developing the condition is helpful as there is evidence that the incidence of preeclampsia can be reduced with low dose aspirin taken in pregnancy. Accurately predicting the risk of preeclampsia allows for more targeted aspirin prophylaxis and a greater opportunity for early detection of maternal and/or fetal complications associated with impaired placentation through a schedule of enhanced antenatal surveillance.…”

Section: Discussionmentioning

confidence: 99%

The Role of Zinc-Rich Food Consumption on Zinc Level and the Incident of Preeclampsia

Hartono

Lukas²,

Mappaware³

et al. 2023

Obgynia

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Objective: Investigate the correlation between dietary intake of zinc, preeclampsia and blood zinc levels. Methods: This study, which compared pregnant women in the third trimester at the Wahidin Sudirohusodo Hospital and the educational network hospital with and without preeclampsia, used a Cross Sectional methodology. Zinc level testing was carried out at Prodia using ICP-MS method. Mann Whitney, Kruskal Wallis, and chi square tests were used to examine the data. Results: Preeclampsia group (n=38) and control group (n=40) were two groups made up of a total of 78 pregnant women. Zn level of severe preeclampsia (47.73 ± 11.23 ng/mL) was lower than preeclampsia (50.50 ± 13.59 ng/mL) and non-preeclampsia (50.58 ± 10.12ng/mL), but not significantly. Lower zinc rich-food consumption was a significant effect on zinc deficiency (p< 0.05), and was no significant effect on preeclampsia (p > 0.05). Conclusion: Low intake of zinc-rich foods and occasionally exposure to cigarette smoke are the causes of zinc insufficiency in third trimester pregnancy, but has little impact on the occurrence of preeclampsia. Peranan Konsumsi Makanan Kaya Zink terhadap Kadar Zink dan Insiden Preeklamsia Abstrak Tujuan: Mengetahui korelasi antara asupan zink, preeklamsia dan tingkat zink serum. Metode: Penelitian ini membandingkan ibu hamil trimester III di RS Wahidin Sudirohusodo dan RS jejaring pendidikan dengan dan tanpa preeklampsia menggunakan metodologi Cross Sectional. Pengujian kadar zink dilakukan di Prodia dengan menggunakan metode ICP-MS. Uji Mann Whitney, Kruskal Wallis dan Chi Square digunakan untuk menganalisis data. Hasil: Kelompok preeklamsia (n=38) dan kelompok kontrol (n=40) adalah dua kelompok yang terdiri dari total 78 ibu hamil. Kadar Zn preeklamsia berat (47.73 ± 11.23 ng/mL) lebih rendah dibandingkan preeklamsia (50.50 ± 13.59 ng/mL) dan non preeklamsia (50.58 ± 10.12ng/mL), tetapi tidak bermakna. Rendahnya konsumsi makanan kaya zink berpengaruh signifikan terhadap defisiensi zink (p<0.05), namun tidak signifikan terhadap kejadian preeklamsia (p>0.05). Kesimpulan: Diet rendah zink dan paparan asap rokok adalah penyebab defisiensi zink pada kehamilan trimester III, tetapi memiliki dampak kecil terhadap insiden preeklamsia. Kata kunci: preeklamsia, kehamilan, zink

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Reviewing Accuracy of First Trimester Screening for Preeclampsia Using Maternal Factors and Biomarkers

Cited by 12 publications

References 79 publications

Feasibility of Universal Screening for Preeclampsia Risk and Aspirin Recommendation in the Ultrasound Unit

Feasibility of Universal Screening for Preeclampsia Risk and Aspirin Recommendation in the Ultrasound Unit

Multi-centre deep learning for placenta segmentation in obstetric ultrasound with multi-observer and cross-country generalization

The Role of Zinc-Rich Food Consumption on Zinc Level and the Incident of Preeclampsia

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