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Content archived on 2024-05-29

Early pregnancy ultrasound and biochemical markers of pre-eclampsia and growth restriction


Pre-eclampsia (PE) complicates 8-10% of pregnancies and represents one of the leading causes of maternal mortality and morbidity. PE is also a major cause of fetal mortality and morbidity, particularly as a result of placental abruption, intra-uterine growth restriction (IUGR) and premature delivery. At present, no early and reliable screening test for PE or IUGR is available. The main objective of this project is to investigate the possibility of combining multiple early pregnancy ultrasound and biochemical markers in order to identify pregnancies at high risk of subsequently developing PE or IUGR. This will involve the assessment of uterine artery flow by Doppler ultrasound, and the determination of multiple maternal serum and urinary markers, in order to identify the best combination of markers to include in a multivariate screening model. The investigations will be repeated at two different gestational intervals in the same unselected pregnant population: 10-14 weeks and 15-18 weeks of gestation. The inno vative approach of the present project is mainly represented by:
a) combining uterine artery assessment and a panel of maternal serum and urine markers. This approach has proved to be extremely successful in screening for other conditions in pregnancy.
b) assessing the screening value of these markers at two gestational intervals in early pregnancy (10-14 weeks and 15-18 weeks), at which stage preventive measures to modify the natural history of the condition are likely to be effective, as opposed to screening tests performed later in pregnancy (from 20 weeks onwards). If successful, the project would therefore be able to provide a reliable early screening tool, and open the way to a series of interventional trials to evaluate the efficacy of the preventive strategies available. In the long term, this may lead to a dramatic reduction of the maternal and fetal/neonatal morbidity and mortality caused by PE and IUGR.

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Largo Rosanna Benzi, 5

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