Effect of routine first trimester combined screening for pre
The study evaluates the effect of the first trimester combined Fetal Medicine Foundation (FMF) based pre-eclampsia screening on rates of fetal small for gestational age (SGA) birth and adverse pregnancy outcome.

Secondary analysis of first-trimester screening for pre-eclampsia: 7720 screened according to NICE risk-based approach and 4841 by FMF multimodal approach combining risk factors, blood pressure, PAPP-A, and uterine Doppler indices. Package of care for FMF screened group included 150mg aspirin prophylaxis, ultrasound at 28 and 36?weeks, and scheduled delivery at 40?weeks gestation. Outcome measures include SGA at birth, admission to the neonatal unit (NNU), intrauterine death, neonatal death, and hypoxic-ischaemic encephalopathy by interrupted time series (ITS) analysis.

There was no significant change in the rates of intrauterine demise, neonatal death, and hypoxic-ischaemic encephalopathy. ITS analysis showed a significant reduction in term SGA birth <10th centile at 21 months post-implementation, with a relative effect reduction of 45.1% - but not for SGA birth <5th or 3rd centile.

First trimester FMF combined screening for pre-eclampsia with elective birth from 40?weeks’ gestation resulted in a significant relative 45% effect reduction for term SGA birth at <10th centile, but not SGA at <5th or 3rd centile.

Ultrasound in Obstetrics & Gynecology
Source: https://doi.org/10.1002/uog.23741