Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

First Trimester Screening for Preeclampsia

Am J Obstet Gynecol; ePub 2017 Oct 30; Sonek, et al

Screening for preeclampsia at 11-13+6 weeks’ gestation using maternal characteristics and biomarkers is associated with a high detection rate for a low false positive rate, while screening for late onset preeclampsia yields a much poorer performance. This according to a prospective observational non-intervention cohort study which included patients who presented for an ultrasound examination between 11 and 13+6 weeks’ gestation. Researchers found:

  • 1,288 patients were screened; 1,068 (83%) were available for analysis.
  • 46 (4.3%) patients developed preeclampsia, with 13 (1.22%) having early-onset preeclampsia (EOPE) and 33 (3.09%) having later-onset preeclampsia (LOPE).
  • Using maternal characteristics, serum biomarkers, and uterine artery PI, the detection rates (DR) of EOPE for either 5% or 10% false positive rates (FPR) was 85%.
  • Using the same protocol, the DRs for PE with delivery prior to 37 weeks were 52% and 60% for 5% and 10% FPR, respectively.
  • Based on maternal characteristics, the DRs for LOPE were 15% and 48% for 5% and 10%, while for preeclampsia at ≥37 weeks’ gestation the DRs were 24% and 43%, respectively.
Citation:

Sonek J, Krantz D, Carmichael J, et al. First trimester screening for early and late preeclampsia using maternal characteristics, biomarkers, and estimated placental volume. [Published online ahead of print October 30, 2017]. Am J Obstet Gynecol. doi:10.1016/j.ajog.2017.10.024.

This Week's Must Reads

ACOG Discourages Direct-to-Consumer Genetic Testing, Obstet Gynecol; ePub 2017 Nov; ACOG

Interpregnancy Interval After Pregnancy Loss, Obstet Gynecol; ePub 2017 Nov 3; Sundermann, et al

Opioid Prescribing & Patient Use After Hysterectomy, Obstet Gynecol; ePub 2017 Nov 3; As-Sanie, et al

IUD Retention After Cesarean or Vaginal Delivery, Contraception; ePub 2017 Nov 8; Colwill, et al

Discontinuation of Oral HT & Sexual Activity, Menopause; ePub 2017 Nov 6; Gass, et al

Must Reads in Obstetrics

Interpregnancy Interval After Pregnancy Loss, Obstet Gynecol; ePub 2017 Nov 3; Sundermann, et al

ACOG Offers Recommendations for Vaginal Seeding , Obstet Gynecol; ePub 2017 Nov; ACOG, et al

First Trimester Screening for Preeclampsia, Am J Obstet Gynecol; ePub 2017 Oct 30; Sonek, et al

Assessing Vaginal Birth After Cesarean Delivery, Obstet Gynecol; ePub 2017 Nov; ACOG, et al

Management of Bleeding in Late Preterm Period, Am J Obstet Gynecol; ePub 2017 Oct 25; Gyamfi-Bannerman