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Screening for Preeclampsia and Fetal Growth Restriction in the First Trimester in Women without Chronic Hypertension

Background: Nowadays, it is possible to identify a group at increased risk of preeclampsia (PE) and fetal growth restriction (FGR) using the principles of the Fetal Medicine Foundation (FMF). It has been established for several years that acetylsalicylic acid (ASA) reduces the incidence of PE and FG...

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Autores principales: Tousty, Piotr, Fraszczyk-Tousty, Magda, Golara, Anna, Zahorowska, Adrianna, Sławiński, Michał, Dzidek, Sylwia, Jasiak-Jóźwik, Hanna, Nawceniak-Balczerska, Magda, Kordek, Agnieszka, Kwiatkowska, Ewa, Cymbaluk-Płoska, Aneta, Torbé, Andrzej, Kwiatkowski, Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488103/
https://www.ncbi.nlm.nih.gov/pubmed/37685649
http://dx.doi.org/10.3390/jcm12175582
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author Tousty, Piotr
Fraszczyk-Tousty, Magda
Golara, Anna
Zahorowska, Adrianna
Sławiński, Michał
Dzidek, Sylwia
Jasiak-Jóźwik, Hanna
Nawceniak-Balczerska, Magda
Kordek, Agnieszka
Kwiatkowska, Ewa
Cymbaluk-Płoska, Aneta
Torbé, Andrzej
Kwiatkowski, Sebastian
author_facet Tousty, Piotr
Fraszczyk-Tousty, Magda
Golara, Anna
Zahorowska, Adrianna
Sławiński, Michał
Dzidek, Sylwia
Jasiak-Jóźwik, Hanna
Nawceniak-Balczerska, Magda
Kordek, Agnieszka
Kwiatkowska, Ewa
Cymbaluk-Płoska, Aneta
Torbé, Andrzej
Kwiatkowski, Sebastian
author_sort Tousty, Piotr
collection PubMed
description Background: Nowadays, it is possible to identify a group at increased risk of preeclampsia (PE) and fetal growth restriction (FGR) using the principles of the Fetal Medicine Foundation (FMF). It has been established for several years that acetylsalicylic acid (ASA) reduces the incidence of PE and FGR in high-risk populations. This study aimed to evaluate the implementation of ASA use after the first-trimester screening in a Polish population without chronic hypertension, as well as its impact on perinatal complications. Material and methods: A total of 874 patients were enrolled in the study during the first-trimester ultrasound examination. The risk of PE and FGR was assessed according to the FMF guidelines, which include the maternal history, mean arterial pressure (MAP), uterine artery pulsatility index (UtPI), pregnancy-associated plasma protein A (PAPP-A) and placental growth factor (PLGF). Among patients with a risk higher than >1:100, ASA was administered at a dose of 150 mg. Perinatal outcomes were assessed among the different groups. Results: When comparing women in the high-risk group with those in the low-risk group, a statistically significantly higher risk of pregnancy complications was observed in the high-risk group. These complications included pregnancy-induced hypertension (PIH) (OR 3.6 (1.9–7)), any PE (OR 7.8 (3–20)), late-onset PE (OR 8.5 (3.3–22.4)), FGR or small for gestational age (SGA) (OR 4.8 (2.5–9.2)), and gestational diabetes mellitus type 1 (GDM1) (OR 2.4 (1.4–4.2)). The pregnancies in the high-risk group were more likely to end with a cesarean section (OR 1.9 (1.2–3.1)), while the newborns had significantly lower weights (<10 pc (OR 2.9 (1.2–6.9)), <3 pc (OR 10.2 (2.5–41.7))). Conclusions: The first-trimester screening test for PE and FGR is a necessary and effective tool in identifying high-risk pregnancies. ASA prophylaxis among high-risk patients may have the most beneficial effect. Furthermore, this screening tool may significantly reduce the incidence of early-onset PE (eo-PE).
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spelling pubmed-104881032023-09-09 Screening for Preeclampsia and Fetal Growth Restriction in the First Trimester in Women without Chronic Hypertension Tousty, Piotr Fraszczyk-Tousty, Magda Golara, Anna Zahorowska, Adrianna Sławiński, Michał Dzidek, Sylwia Jasiak-Jóźwik, Hanna Nawceniak-Balczerska, Magda Kordek, Agnieszka Kwiatkowska, Ewa Cymbaluk-Płoska, Aneta Torbé, Andrzej Kwiatkowski, Sebastian J Clin Med Article Background: Nowadays, it is possible to identify a group at increased risk of preeclampsia (PE) and fetal growth restriction (FGR) using the principles of the Fetal Medicine Foundation (FMF). It has been established for several years that acetylsalicylic acid (ASA) reduces the incidence of PE and FGR in high-risk populations. This study aimed to evaluate the implementation of ASA use after the first-trimester screening in a Polish population without chronic hypertension, as well as its impact on perinatal complications. Material and methods: A total of 874 patients were enrolled in the study during the first-trimester ultrasound examination. The risk of PE and FGR was assessed according to the FMF guidelines, which include the maternal history, mean arterial pressure (MAP), uterine artery pulsatility index (UtPI), pregnancy-associated plasma protein A (PAPP-A) and placental growth factor (PLGF). Among patients with a risk higher than >1:100, ASA was administered at a dose of 150 mg. Perinatal outcomes were assessed among the different groups. Results: When comparing women in the high-risk group with those in the low-risk group, a statistically significantly higher risk of pregnancy complications was observed in the high-risk group. These complications included pregnancy-induced hypertension (PIH) (OR 3.6 (1.9–7)), any PE (OR 7.8 (3–20)), late-onset PE (OR 8.5 (3.3–22.4)), FGR or small for gestational age (SGA) (OR 4.8 (2.5–9.2)), and gestational diabetes mellitus type 1 (GDM1) (OR 2.4 (1.4–4.2)). The pregnancies in the high-risk group were more likely to end with a cesarean section (OR 1.9 (1.2–3.1)), while the newborns had significantly lower weights (<10 pc (OR 2.9 (1.2–6.9)), <3 pc (OR 10.2 (2.5–41.7))). Conclusions: The first-trimester screening test for PE and FGR is a necessary and effective tool in identifying high-risk pregnancies. ASA prophylaxis among high-risk patients may have the most beneficial effect. Furthermore, this screening tool may significantly reduce the incidence of early-onset PE (eo-PE). MDPI 2023-08-27 /pmc/articles/PMC10488103/ /pubmed/37685649 http://dx.doi.org/10.3390/jcm12175582 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tousty, Piotr
Fraszczyk-Tousty, Magda
Golara, Anna
Zahorowska, Adrianna
Sławiński, Michał
Dzidek, Sylwia
Jasiak-Jóźwik, Hanna
Nawceniak-Balczerska, Magda
Kordek, Agnieszka
Kwiatkowska, Ewa
Cymbaluk-Płoska, Aneta
Torbé, Andrzej
Kwiatkowski, Sebastian
Screening for Preeclampsia and Fetal Growth Restriction in the First Trimester in Women without Chronic Hypertension
title Screening for Preeclampsia and Fetal Growth Restriction in the First Trimester in Women without Chronic Hypertension
title_full Screening for Preeclampsia and Fetal Growth Restriction in the First Trimester in Women without Chronic Hypertension
title_fullStr Screening for Preeclampsia and Fetal Growth Restriction in the First Trimester in Women without Chronic Hypertension
title_full_unstemmed Screening for Preeclampsia and Fetal Growth Restriction in the First Trimester in Women without Chronic Hypertension
title_short Screening for Preeclampsia and Fetal Growth Restriction in the First Trimester in Women without Chronic Hypertension
title_sort screening for preeclampsia and fetal growth restriction in the first trimester in women without chronic hypertension
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488103/
https://www.ncbi.nlm.nih.gov/pubmed/37685649
http://dx.doi.org/10.3390/jcm12175582
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