OBJECTIVE: Effective screening for @entity1468 resulting in delivery at <37 weeks' gestation (preterm-PE) is provided by a combination of maternal factors, mean arterial pressure (MAP), uterine artery pulsatility index (UTPI) and serum @entity7309 ( @entity7309 ) at 11-13 or 19-24 weeks' gestation. This study explores the possibility of carrying out routine screening for preterm-PE by maternal factors and MAP in all pregnancies and reserving measurements of UTPI and @entity7309 only for a subgroup of the population selected on the basis of the risk derived from screening by maternal factors and MAP alone. METHODS: The data for the study were derived from prospective screening for adverse obstetric outcomes in @entity1 attending for their routine hospital visit at 11-13 and / or 19-24 weeks' gestation. Bayes theorem was used to derive the a priori risk for preterm-PE from maternal factors and MAP. The posterior risk was obtained by the addition of UTPI and @entity7309 . We estimated the detection rate (DR) of preterm-PE, at an overall false positive rate (FPR) of 10%, from a policy in which first-stage screening by a combination of maternal factors and MAP defines a screen-positive, screen-negative and intermediate-risk group, which then undergoes second-stage screening with UTPI and @entity7309 . RESULTS: At 11-13 weeks' gestation, the model-based DR of preterm-PE, at 10% FPR, in screening the whole population by maternal factors, MAP, UTPI and @entity7309 was 74%. A similar DR was achieved by two-stage screening with maternal factors and MAP in the first-stage and reserving measurements of UTPI and @entity7309 for the second-stage to only 50% of the population. If second-stage screening was offered to 30% of the population, there would be only a small reduction in DR from 74% to 71%. At 19-24 weeks, the model-based DR of preterm-PE, at 10% FPR, in screening the whole population by maternal factors, MAP, UTPI and @entity7309 was 84%. A similar DR was achieved by two-stage screening with measurements of UTPI and @entity7309 in only 80% of the population; if second-stage screening was offered to 40% of the population, the DR would be reduced from 84% to 81%. CONCLUSIONS: High DR of preterm-PE can be achieved by two-stage screening in the first- and second-trimester with maternal factors and MAP in the whole population and measurements of UTPI and @entity7309 in only some of the pregnancies.

Contingent screening for XXXX .

@entity1 :: ('9606', 'Species') :: ['women'] @entity7309 :: ('5228', 'Gene') :: ['PLGF', 'placental growth factor'] @entity1468 :: ('MESH:D011225', 'Disease') :: ['preeclampsia']
@entity1468 :: (MESH:D011225,Disease) :: ['preterm preeclampsia']
