First Trimester Prediction of Preeclampsia and Fetal Growth Restriction

Preeclampsia (PE) is a condition which affects approximately 2% of all pregnancies and can
be a major cause of maternal and perinatal morbidity/mortality (2). The suspected underlying
mechanism of PE is thought to be impaired trophoblastic invasion of the maternal spiral
arteries leading to impaired placental perfusion, placental ischemia and subsequent
development of endothelial dysfunction (3). There is evidence that PE, which is commonly
associated with fetal growth restriction, can be predicted effectively at 11-13 weeks
gestational age by combined screening algorithms combining uterine artery pulsatility index
(PI), maternal mean arterial pressure (MAP) and maternal serum concentrations of placental
products including but not limited to plasma protein A (PAPP-A), and placental growth factor
(PLGF) (4-6).

Aim of Study/Hypothesis:

The aim of this study is to develop an algorithm based on the combination of maternal
factors, uterine artery pulsatility index, mean arterial pressure, placental volume and
serum biomarkers to estimate patient specific risks for the development of Preeclampsia in a
US population.

Inclusion Criteria:

All patients during their first trimester visit

Exclusion Criteria:

Fetal anomalies Pregnancies ending in termination, miscarriage or fetal death prior to 22
weeks and cases with no pregnancy follow up.