Preeclampsia (PE) remains one of the leading causes of perinatal morbidity and mortality. Several guidelines recommend assessing the risk of PE based on maternal risk factors. A combination of maternal risk factors such as maternal demographic characteristics, medical history, and biomarkers such as maternal arterial blood pressure, uterine artery Doppler pulsatility index, and maternal serum biochemical markers (placental growth factor and pregnancy-associated plasma protein-A) is considered the best predictor for preterm PE, but not for term PE. The combined screening was superior to screening for maternal risk factors only in terms of predictive ability for preterm PE. According to the ASpirin for evidence-based PREeclampsia prevention (ASPRE) trial, when low-dose (150 mg/day) aspirin was administered to high-risk women from 11 to 14 weeks to 36 weeks of gestation, preterm PE reduced by 62%. Low-dose aspirin started before 16 weeks of gestation (>100 mg/day) reduced the risk of preterm PE. To prevent PE occurrence, it is crucial to assess the risk of PE in early pregnancy.
Cuesta C, Grosso AL, Chou D, et al. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Edgardo Abalos, Eur J Obstet Gynecol Reprod Biol 2013;170(1):1–7. DOI: 10.1016/j.ejogrb.2013.05.005.
Semin DL. The global impact of pre-eclampsia and eclampsia. Perinatol 2009;33(3):130–137.
Steegers EA, von Dadelszen P, Duvekot JJ, et al. Pre-eclampsia. Lancet 2010;376(9741):631–644. DOI: 10.1016/S0140-6736(10)60279-6.
Brown MA, Magee LA, Kenny LC, et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens 2018;13:291–310. DOI: 10.1016/j.preghy.2018.05.004.
Poon LC, Shennan A, Hyett JA, et al. The international federation of gynecology and obstetrics (FIGO) initiative on pre-eclampsia: a pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet 2019;145(Suppl 1 Suppl 1):1–33. DOI: 10.1002/ijgo.12802.
Davey DA, MacGillivray I. The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol 1988;158(4):892–898. DOI: 10.1016/0002-9378(88)90090-7.
ACOG committee opinion no. 743: low-dose aspirin use during pregnancy. Obstet Gynecol 2018;132(1):e44–e52. DOI: 10.1097/AOG.0000000000002708.
National Institute for Health and Care Excellence. Hypertension in pregnancy: diagnosis and management. 2019. https://www.nice.org.uk/guidance/ng133. Accessed 16 March 2021.
WHO Recommendations for Prevention and Treatment of Pre-eclampsia and Eclampsia. Geneva: World Health Organization; 2011. pp. 13–15.
Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ task force on hypertension in pregnancy. Obstet Gynecol 2013;122(5):1122–1131. DOI: 10.1097/01.AOG.0000437382.03963.88.
O’Gorman N, Wright D, Poon LC, et al. Multicenter screening for pre-eclampsia by maternal factors and biomarkers at 11–13 weeks’ gestation: comparison with NICE guidelines and ACOG recommendations. Ultrasound Obstet Gynecol 2017;49(6):756–760. DOI: 10.1002/uog.17455.
O’Brien E, Atkins N, Stergiou G, et al. European Society of Hypertension International Protocol Revision 2010 for the validation of blood pressure measuring devices in adults. Blood Press Monit 2010;15(1):23–38. DOI: 10.1097/MBP.0b013e3283360e98.
Association for the Advancement of Medical Instrumentation. American National Standard Electronic or Automated Sphygmomanometers ANSI/AAMI SP10-1987. Arlington, VA: Association for the Advancement of Medical Instrumentation; 1987.
Association for the Advancement of Medical Instrumentation. American National Standard Manual, Electronic or Automated Sphygmomanometers ANSI/AAMI SP10-2002/A1. Arlington, VA: Association for the Advancement of Medical Instrumentation; 2003.
Association for the Advancement of Medical Instrumentation. American National Standard ANSI/AAMI/ISO 81060-2:2013 Non-invasive Sphygmomanometers -Part 2: Clinical Investigation of Automated Measurement Type. Arlington, VA: Association for the Advancement of Medical Instrumentation; 2013.
O’Brien E, Petrie J, Littler W, et al. An outline of the revised British Hypertension Society Protocol for the evaluation of blood pressure measuring devices. J Hypertens 1993;11(6):677–679. DOI: 10.1097/00004872-199306000-00013.
O’Brien E, Petrie J, Littler W, et al. The British Hypertension Society protocol for the evaluation of automated and semi-automated blood pressure measuring devices with special reference to ambulatory systems. J Hypertens 1990;8(7):607–619. DOI: 10.1097/00004872-199007000-00004.
Poon LCY, Zymeri NA, Zamprakou A, et al. Protocol for measurement of mean arterial pressure at 11-13 weeks’ gestation. Fetal Diagn Ther 2012;31(1):42–48. DOI: 10.1159/000335366.
Cnossen JS, Vollebregt KC, de Vrieze N, et al. Accuracy of mean arterial pressure and blood pressure measurements in predicting pre-eclampsia: systematic review and meta-analysis. BMJ 2008;336(7653):1117–1120. DOI: 10.1136/bmj.39540.522049.BE.
Gasse C, Boutin A, Coté M, et al. First-trimester mean arterial blood pressure and the risk of preeclampsia: the great obstetrical syndromes (GOS) study. Pregnancy Hypertens 2018;12:178–182. DOI: 10.1016/j.preghy.2017.11.005.
Velauthar L, Plana MN, Kalidindi M, et al. First-trimester uterine artery Doppler and adverse pregnancy outcome: a meta-analysis involving 55,974 women. Ultrasound Obstet Gynecol 2014;43(5):500–507. DOI: 10.1002/uog.13275.
Khalil A, Garcia-Mandujano R, Maiz N, et al. Longitudinal changes in uterine artery Doppler and blood pressure and risk of pre-eclampsia. Ultrasound Obstet Gynecol 2014;43(5):541–547. DOI: 10.1002/uog.13257.
Sotiriadis A, Hernandez-Andrade E, da Silva Costa F, et al. ISUOG practice guidelines: role of ultrasound in screening for and follow-up of pre-eclampsia. Ultrasound Obstet Gynecol 2019;53(1):7–22. DOI: 10.1002/uog.20105.
Bhide A, Acharya G, Bilardo CM, et al. ISUOG practice guidelines: use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol 2013;41(2):233–239. DOI: 10.1002/uog.12371.
Khalil A, Nicolaides KH. How to record uterine artery Doppler in the first trimester. Ultrasound Obstet Gynecol 2013;42(4):478–479. DOI: 10.1002/uog.12366.
Chau K, Hennessy A, Makris A. Placental growth factor and pre-eclampsia. J Hum Hypertens 2017;31(12):782–786. DOI: 10.1038/jhh.2017.61.
Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med 2004;350(7):672–683. DOI: 10.1056/NEJMoa031884.
Zhong Y, Zhu F, Ding Y. Serum screening in first trimester to predict pre-eclampsia, small for gestational age and preterm delivery: systematic review and meta-analysis. BMC Pregnancy Childbirth 2015;15(1):191. DOI: 10.1186/s12884-015-0608-y.
Lawrence JB, Oxvig C, Overgaard MT, et al. The insulin-like growth factor (IGF)-dependent IGF binding protein-4 protease secreted by human fibroblasts is pregnancy-associated plasma protein-A. ProcNatl Acad Sci USA 1999;96(6):3149–3153. DOI: 10.1073/pnas.96.6.3149.
Dugoff L, Hobbins JC, Malone FD, et al. First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: a population-based screening study (the FASTER Trial). Am J Obstet Gynecol 2004;191(4):1446–1451. DOI: 10.1016/j.ajog.2004.06.052.
Akolekar R, Syngelaki A, Poon LC, et al. Competing risks model in early screening for preeclampsia by biophysical and biochemical markers. Fetal Diagn Ther 2013;33(1):8–15. DOI: 10.1159/000341264.
O’Gorman N, Wright D, Syngelaki A, et al. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11-13 weeks gestation. Am J Obstet Gynecol 2016;214(1):103.e1–103.e12. DOI: 10.1016/j.ajog.2015.08.034.
Tan MY, Syngelaki A, Poon LC, et al. Screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks’ gestation. Ultrasound Obstet Gynecol 2018;52(2):186–195. DOI: 10.1002/uog.19112.
Crandon AJ, Isherwood DM. Effect of aspirin on incidence of pre-eclampsia. Lancet 1979;1(8130):1356. DOI: 10.1016/s0140-6736(79)91996-2.
Masotti G, Galanti G, Poggesi L, et al. Differential inhibition of prostacyclin production and platelet aggregation by aspirin. Lancet 1979;2(8154):1213–1217. DOI: 10.1016/s0140-6736(79)92334-1.
Beaufils M, Uzan S, Donsimoni R, et al. Prevention of pre-eclampsia by early antiplatelet therapy. Lancet 1985;1(8433):840–842. DOI: 10.1016/s0140-6736(85)92207-x.
Rolnik DL, Wright D, Poon LC, et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med 2017;377(7):613–622. DOI: 10.1056/NEJMoa1704559.
Roberge S, Bujold E, Nicolaides KH. Aspirin for the prevention of preterm and term preeclampsia: systematic review and metaanalysis. Am J Obstet Gynecol 2018;218(3):287–293. DOI: 10.1016/j.ajog.2017.11.561.
Hofmeyr GJ, Lawrie TA, Atallah AN, et al. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev 2018(10):CD001059. DOI: 10.1002/14651858.CD001059.pub5.