Obstetric
Pre-eclampsia screening

Pre-eclampsia (PE) is a common condition affecting approximately 2-5% of pregnant women.  It usually manifests as high blood pressure initially, and can lead to fetal growth restriction and prematurity, and other important clinical issues. In about 0.5% of pregnancies, the fetus and mother are severely affected, resulting in pre-term delivery.

Western Ultrasound for Women are pleased to offer screening for Pre-Eclampsia in the First Trimester. This is done by using a combination of ultrasound at 13 1/2 weeks (measurement of blood flow in the maternal uterine arteries), blood tests (Placental Growth Factor and PAPP-A) and clinical factors (including height, weight, blood pressure, family history etc). Using all this information together, screening at 13 1/2 weeks will identify 90% of women who will be affected by early onset pre-eclampsia. This is important as treatment can then be started early, before the condition would normally present clinically. It is believed that treatment before 16 weeks will result in >50% reduction in problems in both mother and baby.

No extra ultrasounds are needed for the Pre-eclampsia screening to be performed. The necessary information will obtained at the early anatomy 13 1/2 week ultrasound.

Depending on the NIPT being performed, we may need additional blood. Otherwise, Placental Growth Factor will need to be performed in order for risks to be calculated.

A questionnaire will need to be filled out at time of the scan, and blood pressure, height and weight will be measured.

The requesting doctor needs to specifically ask for PE screening on the request form.

A recent multicentre double-blind randomised placebo-controlled study has been published in the New England Journal of Medicine supporting the use of aspirin in those identified as high risk for pre-eclampsia in early screening.

www.nejm.org/doi/full/10.1056/NEJMoa1704559