Role of extended first trimester screening (EFTS) in screening of aneuploidy and prediction of pre-eclampsia

Abstract

: To assess the role of extended first trimester screening (EFTS) in early detection and management of preeclampsia.: A total of 501 parturients (aged 18-49 years; GA 11-13 weeks) underwent ETFS quadruple test that included age, sonographic data (CRL, Nuchal Tube (NT), ductus venosus PI) and biochemical tests (b-hCG, Alpha-fetoprotein, PLGF and PAPP-A for Trisomy 21, 18 and 13) levels. All the women were followed up for preeclampsia. Role of independent as well as combined ETFS predictors was assessed for prediction of preeclampsia employing independent samples ‘t’- and Fisher exact tests. ROC analysis was performed for continuous predictors significantly associated with preeclampsia risk. Results have been depicted in terms of sensitivity, specificity, positive and negative predictive values of different ETFS risk predictors.Meanage of women was 28.07±4.77 years. Quadruple test was negative in 422 (84.2%). It was positive for Down’s syndrome/T21 in 23 (4.6%), T21 with increased PLGF in 8 (1.6%) and increased PLGF only in 48 (9.6%) cases. A total of 14 (2.8%) women developed preeclampsia. Older age, T21 risk, PLGF risk and any quadruple test abnormality were significantly associated with preeclampsia (p<0.05). On ROC analysis, the area under the curve value of age for prediction of preeclampsia was 0.940. Among different EFTS risks, age had maximum sensitivity (100%) and specificity (88.3%). Overall quadruple test was 71.4% sensitive and 85.8% specific in prediction of preeclampsia.: EFTS was a useful strategy for reducing the burden of preeclampsia.