The performance of ASPRE based screening in routine clinical practice.

Teddy Golob and Ramesh Ganapathy – Epsom and St Helier NHS trust, London UK. 

 

Objective: 

UK national guidelines from the National Institute of Clinical Care Excellence(NICE) recommend screening for preeclampsia (PE) based on maternal characteristics [1]. There is evidence that such screening has a poor detection rate [2]. The FetalMedicine Foundation (FMF) has proposed a model for screening at 11-13 weeks that includes maternal blood pressure, uterine artery Doppler and  placental growth factor (PLGF) [3]. The objective of our study was to compare the effectiveness of combined screening for PE using the FMF algorithm compared to a maternal-factor based model (NICE). 

 

Design:

This was a retrospective cohort study from January2022 to April 2024. The inclusion criteria was women who consented to screening for PE at 11-13 weeks’ gestation with a viable singleton pregnancy. We excluded multiple pregnancies, fetalabnormalities, miscarriages, terminations and those with incomplete outcome data. PE was defined by ISSHP [4] definition and was divided into early (<34 weeks), preterm (<37 weeks) and term (≥37 weeks’). Detectionrates (DR) and screen positive rates (SPR) were compared between the FMF and NICE models. The study was approved by NHS Health research authority (no. 326047).   

 

Design:

This was a retrospective cohort study from January2022 to April 2024. The inclusion criteria was women who consented to screening for PE at 11-13 weeks’ gestation with a viable singleton pregnancy. We excluded multiple pregnancies, fetalabnormalities, miscarriages, terminations and those with incomplete outcome data. PE was defined by ISSHP [4] definition and was divided into early (<34 weeks), preterm (<37 weeks) and term (≥37 weeks’). Detectionrates (DR) and screen positive rates (SPR) were compared between the FMF and NICE models. The study was approved by NHS Health research authority (no. 326047).   

 

Conclusion:

The FMF algorithm was more accurate at predicting early PE and preterm PE but was not significantly different in its prediction of term PE.  

References: