Early prediction of preeclampsia

Abstract

Effective screening for the development of early onset preeclampsia (PE) can be provided in the first-trimester of pregnancy. Screening by a combination of maternal risk factors, uterine artery Doppler, mean arterial pressure, maternal serum pregnancy-associated plasma protein-A, and placental growth factor can identify about 95% of cases of early onset PE for a false-positive rate of 10%.

Figure 1

Distribution of gestational age at delivery for preeclampsia (PE). In pregnancies at low-risk for PE the gestational age distribution is shifted to the right and in most pregnancies delivery will occur before the development of PE. In pregnancies at high-risk for PE the distribution is shifted to the left. The risk of PE occurring at or before a specified gestational age is given by the area under the distribution curve (black). In the low-risk group the risk of PE at or before 34 weeks' gestation is 0.01 or 1% and in the high-risk group the risk is 0.6 or 60%.

Figure 2

Effects of maternal characteristics (with 95% confidence intervals) on the gestational age at delivery for preeclampsia. This effect is expressed as gestational weeks by which the expected gestational age at delivery for preeclampsia is altered.