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Aim: To develop a combined predictive model for preterm and term pre-eclampsia (PE) during the first trimester of pregnancy., Methods: This investigation was a nested case-control study in singleton pregnancies at the Maternal-Fetal Medicine Unit, University of Chile Hospital. A priori risks for preterm and term PE were calculated by multivariate logistic regression analyses. Biophysical markers were log 10 -transformed and expressed as multiples of the median. A multivariate logistic regression analysis was used to estimate a combined predictive model of preterm and term PE. Detection rates at different cut-off points were determined by a receiver operator curve analysis of a posteriori risks., Results: First trimester mean arterial pressure and uterine artery Doppler pulsatility index were significantly higher in women who develop PE than in the unaffected group. The detection rate of preterm PE based on maternal characteristics and biophysical markers was 72% at a 10% false-positive rate, corresponding to a cut-off risk of 1 in 50. The detection rate for term PE was 30% at a 10% false-positive rate., Conclusion: Preterm PE can be predicted by a combination of maternal characteristics and biophysical markers. However, first trimester screening is less valuable for term PE., (© 2018 Japan Society of Obstetrics and Gynecology.)

Objective: To evaluate the role of cervical length (CL) and uterine artery pulsatility index (UtA-PI) at 11+0 to 13+6 weeks as predictors of spontaneous preterm delivery (sPTD) in a Chilean population., Methods: This was a prospective study of asymptomatic women with singleton pregnancies attending for a nuchal translucency scan at 11+0 to 13+6 weeks' gestation and who underwent a transvaginal scan for evaluation of CL and UtA-PI. Exclusion criteria were fetal and pregnancy complications (other than sPTD) and iatrogenic delivery at<34 weeks. Measurements of CL and UtA-PI were adjusted for fetal crown-rump length and maternal characteristics and expressed as multiples of the median (MoM) of the unaffected group. Prediction of sPTD using maternal and pregnancy characteristics was studied using logistic regression analysis., Results: A total of 3480 women were recruited into the study and, after application of exclusion criteria, 3310 were included in the analysis. The rate of sPTD at<34 weeks was 0.9% (n=31). A previous PTD had occurred in 7.4% of parous women. Patients with sPTD in the index pregnancy were characterized by a significantly higher prevalence of previous PTD (12.9% vs 3.7%, P<0.05). No significant difference was found in either CL or UtA-PI between pregnancies with and without subsequent sPTD. Logistic regression analysis showed that smoking and previous PTD were significantly associated with sPTD at<34 weeks. The combination of these characteristics provided a detection rate of 26% with a false-positive rate of 8%., Conclusions: Neither UtA-PI nor CL during the first trimester was shown to be a useful predictor of early sPTD. However, a combined model that includes smoking and previous PTD predicts approximately one-quarter of those women destined to deliver at<34 weeks, with a false-positive rate of 8%., (Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.)

Objective: To develop a predictive model for pre-eclampsia using clinical, biochemical and ultrasound markers during the first trimester of pregnancy., Methods: This was a nested case-control study within a pre-eclampsia screening project that involved 5367 asymptomatic pregnant women undergoing routine transvaginal uterine artery (UtA) Doppler at 11 + 0 to 13 + 6 weeks. Following exclusions, there were 70 pregnant women who later developed pre-eclampsia and 289 control patients enrolled during the first trimester who had serum or plasma samples taken at enrolment available for the purposes of this study. Of these, 17 pregnancies were diagnosed with early-onset (delivery < 34 weeks) pre-eclampsia and 53 with late-onset (delivery ≥ 34 weeks) pre-eclampsia. The lowest, highest and mean of left and right UtA pulsatility indices (PI) were calculated. Blood samples were stored at -84 °C until biochemical analysis for markers of vasculogenesis was performed. The distributions of the lowest UtA-PI and the biochemical markers were adjusted for maternal characteristics, expressed as multiples of the median (MoM), and compared between groups. Logistic regression analysis was used to evaluate if any variable was significantly associated with pre-eclampsia., Results: Pregnancies that later developed pre-eclampsia were associated with higher maternal prepregnancy body mass index. An increased lowest UtA-PI was significantly associated with both early- and late-onset disease. Placental growth factor (PlGF) MoM was significantly reduced in women who later developed early- or late-onset pre-eclampsia compared with controls (median (interquartile range), 0.69 (0.33-1.46) and 1.10 (0.39-1.56), respectively, vs 1.19 (0.65-1.84), P < 0.05). Different combined models were generated by logistic regression analysis, and the detection rate with a fixed 10% false-positive rate was 47% and 29% for early- and late-onset pre-eclampsia, respectively., Conclusion: Pregnancies that later developed early or late pre-eclampsia were characterized by impaired placentation and an anti-angiogenic state during the first trimester of pregnancy. Regression models which include maternal characteristics, UtA Doppler and PlGF can apparently predict approximately half of pregnancies that will be complicated by early-onset pre-eclampsia. We believe more research in several areas is needed to aid in the creation of a better and more population-specific screening test for pre-eclampsia during the first trimester of pregnancy., (Copyright © 2012 ISUOG. Published by John Wiley & Sons Ltd.)

This article, published in the journal Ultrasound in Obstetrics & Gynecology, evaluates the effectiveness of screening for late-onset pre-eclampsia (PE) between 35 and 38 weeks of gestation using maternal and biophysical factors. The study included 949 pregnancies, with 46 (4.8%) developing PE. The results showed that screening with a combination of maternal factors (age and BMI) and mean arterial pressure (MAP) could identify a high proportion of pregnancies at risk for late-onset PE. The authors suggest that this screening method could be useful in identifying and managing pregnancies at risk for PE. [Extracted from the article]

This article, titled "OP15.05: First trimester fetal growth: a screening tool for small-for-gestational-age newborns," discusses a study that aimed to develop a predictive model for identifying newborns who are small for gestational age (SGA) in the first trimester. The study involved 3,238 women with a singleton pregnancy and assessed factors such as Crown-rump length (CRL) and uterine artery Doppler (UAD). The results showed that reduced CRL growth in the first trimester is associated with SGA below the third percentile. A combined model including maternal characteristics, CRL growth, and UAD can predict around half of pregnancies with preterm SGA. [Extracted from the article]

This article discusses a study conducted at the Fetal Medicine Unit of the University of Chile Hospital between 2018 and 2020. The study aimed to determine the impact of changes in the uterine artery pulsatility index (UtA-PI) on the outcomes of pregnant women using aspirin to prevent preterm pre-eclampsia (PE). The study found that pregnant women at high risk of preterm PE who were treated with aspirin had greater uterine artery vasodilation between the first and second trimesters compared to control pregnant women. However, further research with a larger sample size is needed to confirm these findings. [Extracted from the article]

Objective: To determine whether oral glucose tolerance tests (OGTT) play a role as predictors of preeclampsia (PET) in pregnant women. Methods: A retrospective case-control study was conducted in 2,002 singleton pregnancies that had a uterine artery (UtA) Doppler at 22-25 weeks and an OGTT. The UtA Doppler and OGTT were adjusted based on maternal characteristics, and the results were expressed as multiples of the expected normal median and compared between groups. Logistic regression analysis was used to determine whether maternal characteristics, OGTT, and UtA Doppler significantly contribute to the prediction of early- (<34 weeks), intermediate- (34-37 weeks), or late-onset (>37 weeks) PET. The performance of the screening was determined by ROC curves. Results: Women who developed PET were characterized by an older maternal age, an increased body mass index, and an altered UtA Doppler. The group with intermediate-onset PET was the only one associated with higher 2-hour OGTT levels compared to controls. Combined models were developed via logistic regression analysis using maternal characteristics, UtA Doppler, and OGTT to predict PET. These combined models were able to detect around 74, 42, and 21% of women who later developed early-, intermediate-, or late-onset PET, respectively, with only a 5% false-positive rate. Conclusions: This study shows that the combination of maternal characteristics, second-trimester UtA Doppler, and OGTT is a predictor of the development of PET in healthy pregnant women. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

EP20.21: Combined predictive model of birthweight at diagnosis of early and late onset pre-eclampsia A multivariate linear regression analysis for birthweight prediction combining maternal characteristics, fetal biometry and UtA Doppler was determined for g-PE, e-PE and l-PE. For g-PE, the best birthweight predictive model included UtA z-score, estimated fetal weight (EFW) z-score, maternal smoking habit and diabetes mellitus background (r = 0.88; p < 0.0001). [Extracted from the article]

An abstract of the article "Characterisation of immune patterns in pregnancies defined as high- or low-risk according to first trimester uterine artery Doppler," by M. Lopez and colleagues is presented.