Screening for Term Preeclampsia at 35 to 37 Weeks of Gestation: A Single-Center Experience.

Introduction: Prevention of preeclampsia has short- and long-term benefits for maternal health. Recent data suggest that combined screening at 35-37 weeks of gestation with anamnestic risk factors, mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), and angiogenic profile (sFlt-1/PlGF) detects up to 80% of all tPE. The aim of this retrospective analysis was to test the performance of third-trimester screening for tPE in a single center in Switzerland.

Methods: Singleton pregnancies with complete background risk assessments, MAP, and, if available, UtA-PI and sFlt-1/PlGF from 2018 to 2023 were included and risks were calculated on the FMF London website.

Results: 1,121 pregnancies, including 22 (2.0%) with tPE, were analyzed. Median MAP-MoM [IQR] in tPE was 1.08 [1.00-1.14], compared to 0.98 [0.92-1.04] in controls (p < 0.0001). Median UtA-PI-MoM [IQR] in tPE was 1.04 [0.85-1.27] versus 0.99 [0.82-1.15] (p = 0.56). No sFlt-1/PlGF recordings in tPE were available for analysis. The detection rate in combined screening was 15/22 (68.2%) compared to screening by anamnestic risk factors only of 9/22 (40.9%).

Conclusion: This analysis shows that combined screening at 35-37 weeks of gestation including anamnestic risk factors and MAP performs better than screening by anamnestic risk factors alone. These results should further be verified in a prospective trial including all markers.