The Importance of Screening for Preeclampsia in the First Quarter

The combination of biophysical and biochemical markers, echographic, allows to obtain a rate of detection of preeclampsia of 93%.

The screening of preeclampsia in the 1st quarter plays an important role in the early identification of a pregnancy with high risk of developing this disease. At present there is no way to prevent preeclampsia, once the diagnosis is based on signs and symptoms, making it only possible when the disease manifests itself.

Tracing preeclampsia consider mainly four factors:

  1. The Maternal History should consider prior or family history of preeclampsia, parity, medically assisted procreation, diabetes mellitus, ethnicity, reproductive ages (< 18 years; > 37 years);
  2. The Biophysical Markers are considered the body mass index (BMI) and mean Arterial pressure (MAP);
  3. The Echographic Markers, denoted by the Uterine artery Pulsatility Index (uA-PI);
  4. Biochemical Markers consisting of the pregnancy-associated plasma protein A (PAPP-A) and the Placentar growth factor (PlGF).

Determination of biochemical PAPP-A and Placentar Growth factor (PlGF) is the ideal marker for the early screening of risk of preeclampsia and should be performed at 10-13 weeks + 6 days of gestation. The Placentar growth factor (PlGF) is produced by the placenta and is a angiogénico factor, acting as a vasodilator that increases the diameter of the arteries. Low levels of PlGF contribute to vascular dysfunction, which is one of the symptoms of preeclampsia. The is a high percentage decreased PlGF of pregnancies occurring to preeclampsia. This reduction occurs mainly in the first quarter, hence the importance of screening for preeclampsia in this period of gestation.

The combination of biophysical and biochemical markers, echographic, allows to obtain a rate of detection of preeclampsia of 93%.