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Multicenter screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks' gestation: comparison with NICE guidelines and ACOG recommendations.

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2017

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O'Gorman, N
Wright, D
Poon, L C
Rolnik, D L
Syngelaki, A
de Alvarado, M
Carbone, I F
Dutemeyer, V
Fiolna, M
Frick, A

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Abstract

To compare the performance of screening for pre-eclampsia (PE) based on risk factors from medical history, as recommended by NICE and ACOG, with the method proposed by The Fetal Medicine Foundation (FMF), which uses Bayes' theorem to combine the a-priori risk from maternal factors, derived by a multivariable logistic model, with the results of various combinations of biophysical and biochemical measurements. This was a prospective multicenter study of screening for PE in 8775 singleton pregnancies at 11-13 weeks' gestation. A previously published FMF algorithm was used for the calculation of patient-specific risk of PE in each individual. The detection rates (DRs) and false-positive rates (FPRs) for delivery with PE In the study population, 239 (2.7%) cases developed PE, of which 17 (0.2%), 59 (0.7%) and 180 (2.1%) developed PE Performance of screening for PE at 11-13 weeks' gestation by the FMF algorithm using a combination of maternal factors, MAP, UtA-PI and PlGF, is by far superior to the methods recommended by NICE and ACOG. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

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MeSH Terms

Biomarkers
Female
Gestational Age
Humans
Practice Guidelines as Topic
Pre-Eclampsia
Pregnancy
Pregnancy Trimester, First
Prenatal Diagnosis
Prospective Studies
ROC Curve
Risk Assessment
Societies, Medical
United Kingdom
United States

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Keywords

Bayes' theorem, first-trimester screening, mean arterial pressure, placental growth factor, pre-eclampsia, pregnancy-associated plasma protein-A, pyramid of pregnancy care, survival model, uterine artery Doppler

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