Implementation of routine first-trimester combined screening for preeclampsia based on the Gaussian algorithm: A clinical effectiveness study
Por:
Mendoza, M, Bonacina, E, Serrano, B, Ricart, M, Martin, L, Lopez-Quesada, E, Vives, A, Maroto, A, Garcia-Manau, P, De Antonio, C, Tusquets, C, Moreano, G, Armengol-Alsina, M and Carreras, E
Publicada:
1 dic 2022
Ahead of Print:
1 abr 2022
Resumen:
Objective To evaluate the clinical effectiveness of the routine first-trimester screening for preeclampsia (PE) after being implemented in six Catalan maternities. Methods Participants in the reference group were recruited prospectively between October 2015 and September 2017. Participants in the study group were recruited retrospectively between November 2018 and May 2019, after implementing the screening program. PE risk was assessed between 11 + 0 and 13 + 6 weeks of gestation using the Gaussian algorithm combining maternal characteristics, mean arterial blood pressure, uterine artery pulsatility index, and maternal serum pregnancy-associated plasma protein-A. Women with a risk >= 1/137 were prescribed daily salicylic acid (150 mg) until 36 weeks of gestation. Results Preterm PE occurred in 30 of 2641 participants (1.14%) in the reference group, as compared with 18 of 2848 participants (0.63%) in the study group (OR: 0.55; 95% CI, 0.31-0.99; P = 0.045). In the reference group, 37 participants (1.40%) were admitted to ICU, as compared with 23 participants (0.81%) in the study group (OR: 0.57; 95% CI, 0.34-0.96; P = 0.035). Conclusion The routine first-trimester PE screening can be implemented in a public healthcare setting, leading to a significant reduction in the incidence of preterm PE and of maternal ICU admission.
Filiaciones:
Mendoza, M:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Dept Obstet, Maternal Fetal Med Unit, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Bonacina, E:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Dept Obstet, Maternal Fetal Med Unit, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Serrano, B:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Dept Obstet, Maternal Fetal Med Unit, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
:
Univ Autonoma Barcelona, Hosp Univ Germans Trias & Pujol, Dept Obstet, Maternal Fetal Med Unit, Badalona, Spain
Martin, L:
Univ Rovira & Virgili, Hosp Univ Tarragona Joan XXIII, Dept Obstet, Maternal Fetal Med Unit, Tarragona, Spain
Lopez-Quesada, E:
Univ Barcelona, Hosp Univ Mutua Terrassa, Dept Obstet, Maternal Fetal Med Unit, Terrassa, Spain
Vives, A:
Univ Int Catalunya, Consorci Sanit Terrassa, Dept Obstet, Maternal Fetal Med Unit, Terrassa, Spain
Maroto, A:
Univ Girona, Hosp Univ Girona Doctor Josep Trueta, Dept Obstet, Maternal Fetal Med Unit, Girona, Spain
Garcia-Manau, P:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Dept Obstet, Maternal Fetal Med Unit, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
De Antonio, C:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Dept Obstet, Maternal Fetal Med Unit, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Tusquets, C:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Dept Obstet, Maternal Fetal Med Unit, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Moreano, G:
Univ Autonoma Barcelona, Hosp Univ Germans Trias & Pujol, Dept Obstet, Maternal Fetal Med Unit, Badalona, Spain
Armengol-Alsina, M:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Dept Obstet, Maternal Fetal Med Unit, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Carreras, E:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Dept Obstet, Maternal Fetal Med Unit, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
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