From first-trimester screening to risk stratification of evolving pre-eclampsia in the second and third trimesters of pregnancy: a comprehensive approach.

Poon, Liona C; Galindo, Alberto; Surbek, Daniel; Chantraine, Frederic; Stepan, Holger; Hyett, Jon; Tan, Kok Hian; Verlohren, Stefan (2020). From first-trimester screening to risk stratification of evolving pre-eclampsia in the second and third trimesters of pregnancy: a comprehensive approach. Ultrasound in obstetrics & gynecology, 55(1), pp. 5-12. Wiley InterScience 10.1002/uog.21869

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Preeclampsia and associated hypertensive disorders of pregnancy represent a leading cause of global maternal and neonatal morbidity and mortality. Identification of women at high risk for developing preterm-preeclampsia and prophylaxis with low-dose aspirin has the potential to significantly reduce the rate of preterm-preeclampsia. In addition, risk assessment and monitoring of women in the second and third trimester of pregnancy, to aid in early detection of evolving disease, timely referral to specialist care, and active monitoring of women with confirmed or suspected preeclampsia is essential for improving maternal and neonatal outcomes. The angiogenesis-related biomarkers sFlt-1 and PlGF have been shown to have clinical value to aid in the prediction, diagnosis, and risk stratification of preeclampsia when used either alone or in combination with other risk factors. However, currently there is no consensus on the optimum strategy to link first trimester screening for preterm-preeclampsia with appropriate second and third trimester risk assessment strategies. This opinion paper will outline the current evidence for first trimester preeclampsia screening and prevention, as well as the evidence for various risk stratification approaches for detection of evolving preeclampsia through the second and third trimesters of pregnancy, and proposes a potential model integrating these tools. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Surbek, Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0960-7692

Publisher:

Wiley InterScience

Language:

English

Submitter:

Monika Zehr

Date Deposited:

24 Dec 2019 09:34

Last Modified:

11 Sep 2020 02:30

Publisher DOI:

10.1002/uog.21869

PubMed ID:

31503374

Uncontrolled Keywords:

Preeclampsia aspirin prophylaxis first trimester screening management pregnancy care risk stratification sFlt-1/PlGF ratio second and third trimester

BORIS DOI:

10.7892/boris.136429

URI:

https://boris.unibe.ch/id/eprint/136429

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