Augmenting the Early Detection of Risk for Preeclampsia

Initiating first-trimester low-dose aspirin in pregnant women at risk for preeclampsia reduces the likelihood of preterm disease onset by 67% (Am J Obstet Gynecol 2018; 218:287) — but attaining this benefit requires timely identification of such women. In a prospective cohort study of 16,747 first-trimester singleton pregnancies, investigators in England assessed the efficacy of two approaches for identifying women at high risk for developing preeclampsia: Maternal medical history (MMH) alone or enhanced with biomarker measurement (mean arterial pressure, uterine artery pulsatility index [UtA-PI], and circulating pregnancy-associated plasma protein-A [PAPP-A] and placental growth factor [PlGF]). For the enhanced screening, preeclampsia risk…