Evaluation of the effectiveness of first trimester screening of pregnancy in the implementation of “major obstetric syndromes” in the Samara region

Aim – to evaluate the effectiveness of first trimester screening in predicting major obstetric syndromes: preeclampsia (PE), intrauterine growth restriction (IGR) and preterm birth (PB).

Material and methods. We analyzed the results of first trimester screening and pregnancy outcomes in 992 patients included in the risk groups for PE, IGR and PB according to the Astrae program.

Results. Preeclampsia leads in the number of calculated risks, both isolated, 47.4%, and in combination with IGR, 27.6%. 75.4% of women did not realize the probability of one or another pregnancy complication despite the fact that they were assigned to the risk group based on the screening results. The incidence rate of preeclampsia was 3.6%, and that of IGR was 9%. Preeclampsia occurred in 4.3% of patients in the corresponding risk group, IGR, in 11.6%, respectively. In 31.2% of women with IGR, low risks were calculated for IGR, and high risks for PE. However, the established risk of IGR is associated with an increase in the frequency of spontaneous miscarriage in the observed group. In the group of calculated high risk for PR, this complication did not occur in any case, while in other risk groups (IGR and PE), premature births were observed in 5.3% of cases.

Conclusion. The first trimester screening generally accepted in the Russian Federation is quite inaccurate in terms of risk prediction. The obtained characteristics of the effectiveness of this study suggest the inevitability of revising approaches to first trimester screening and replacing the studied biomarkers. In the group we observed, patients who subsequently experienced spontaneous miscarriage had significantly increased risks of IGR. This fact should be verified on a larger sample of patients with such an unfavorable pregnancy outcome, which requires further research in this area.