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Performance of screening

Screening at 11-13 weeks

The objective of screening for PE at 11-13 weeks’ gestation is to identify the cases that would benefit from prophylactic use of aspirin that reduces the risk of preterm PE by more than 60%.

Combined screening by maternal factors, MAP, UTPI and PLGF predicts about 90% of early PE (<34 weeks), 75% of preterm PE (<37 weeks) and 45% of term PE (≥37 weeks), at screen positive rate of 10%.

  • Inclusion of PAPP-A and sFLT-1 does not improve the performance of screening.

The traditional approach of identifying women at high-risk of PE that could benefit from aspirin is based on maternal factors. The National Institute for Health and Clinical Excellence (NICE) in the UK recommends the identification of the high-risk group on the basis of 10 factors from maternal characteristics and medical history; this method identifies only about 40% of cases of preterm PE and 35% of term PE. The American College of Obstetricians and Gynecologists (ACOG) recommends the use of aspirin in women with a history of PE in ≥2 pregnancies or history of PE with delivery <34 weeks; this method identifies 5% of cases of preterm PE and 2% of term PE.