Stratification of pregnancy management
11-13 weeks’ gestation
Screening of the whole population by a combination of maternal factors, MAP, UTPI and PLGF can be carried out and on the basis of risks for PE the pregnancies are stratified into two management pathways:
- High-risk group (risk for PE at <37 weeks of ≥1 in 100). This group constitutes about 10% of the total and contains 75% of those that develop PE at <37 weeks. Treatment with aspirin (150 mg/day) taken at bed time from 12 to 36 weeks reduces the risk of preterm PE by about 60%. The patients should be encouraged to take the drug regularly because if the compliance is ≥90% the reduction in risk may be 75%.
- Low-risk group (risk for PE at <37 weeks of <1 in 100). This group, which constitutes 90% of the total, can be reassured that development of PE at <37 weeks is unlikely, but they require reassessment of risk at 22 weeks’ gestation.