CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(01): 098-100
DOI: 10.1055/s-0042-1759856
Brief Report

Effectiveness of the First Trimester Samrakshan Protocol for the Identification of Pregnant Women at High Risk for Preterm Pre-eclampsia

Rijo Mathew Choorakuttil
1   Department of Clinical Radiology, AMMA Center for Diagnosis and Preventive Medicine, Kochi, Kerala, India
,
Bavaharan Rajalingam
2   Department of Clinical Radiology, Fetocare Magnum Imaging and Diagnostics, Trichy, Tamil Nadu, India
,
Shilpa R. Satarkar
3   Department of Clinical Radiology, Antarang Sonography and Colour Doppler Center, Satarkar Hospital, Aurangabad, Maharashtra, India
,
Lalit K. Sharma
4   Department of Clinical Radiology, Raj Sonography and X- Ray Clinic, Guna, Madhya Pradesh, India
,
Anjali Gupta
5   Department of Clinical Radiology, Anjali Ultrasound and Colour Doppler Centre, Agra, Uttar Pradesh, India
,
Akanksha Baghel
6   Department of Clinical Radiology, Baghel Sonography Center, Harda, Madhya Pradesh, India
,
Neelam Jain
7   Department of Clinical Radiology, Department of Radiodiagnosis, Jain Ultrasound Centre, Jamshedpur, Jharkhand, India
,
Sandhya Dhankar
8   Department of Clinical Radiology, Faith Diagnostic Center, Chandigarh, India
,
9   Department of Clinical Radiology, Images Ultrasound Center, Naveda Healthcare Centre, New Delhi, India
,
Gulab Chhajer
10   Department of Clinical Radiology, Department of Radiodiagnosis, Kushal Imaging and Diagnostic Center, Pali, Rajasthan, India
,
Somya Dwivedi
11   Department of Clinical Radiology, Qura Diagnostics and Research Center, Bhopal, Madhya Pradesh, India
,
Tejashree Y. Patekar
12   Department of Clinical Radiology, Innovision Sonography and Imaging Center, Gangapur, Nashik, India
,
Eesha Rajput
13   Department of Clinical Radiology, INHS Asvini, Mumbai, Maharashtra, India
,
14   Department of Research, AMMA Healthcare Research Gurukul, AMMA Center for Diagnosis and Preventive Medicine, Kochi, Kerala, India
› Institutsangaben

Abstract

Aim To determine the effectiveness of the first trimester Samrakshan protocol for the identification of pregnant women at high risk for preterm pre-eclampsia (PE).

Methods Samrakshan uses a protocol that integrates routine first-trimester ultrasound assessment at 11 to 14 gestation weeks with the measurement of mean arterial blood pressure and mean uterine artery pulsatility index assessment to determine a customized risk for preterm PE and fetal growth restriction. Based on the risk assessment, pregnant women are classified as high or low risk.

Results The protocol had a high specificity (90.4%, 95% CI: 89.4%, 91.2%) and negative predictive value (98.1%, 95% CI: 97.6%, 99%) for preterm PE. The odds ratio and positive likelihood ratio for preterm PE were 16.7 (95% CI: 12.3, 22.6) and 6.64 (95% CI: 5.77, 7.63), respectively.

Conclusions The positive likelihood ratio and odds ratios indicate that pregnant women identified as high risk for preterm PE using the first-trimester protocol of Samrakshan are significantly more likely to develop preterm PE than low-risk women.



Publikationsverlauf

Artikel online veröffentlicht:
26. Dezember 2022

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  • References

  • 1 O'Gorman N, Wright D, Syngelaki A. et al. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11-13 weeks gestation. Am J Obstet Gynecol 2016; 214 (01) 103.e1-103.e12
  • 2 Bhide A, Acharya G, Bilardo CM. et al. ISUOG practice guidelines: use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol 2013; 41 (02) 233-239
  • 3 Sotiriadis A, Hernandez-Andrade E, da Silva Costa F. et al; ISUOG CSC Pre-eclampsia Task Force. ISUOG practice guidelines: role of ultrasound in screening for and follow-up of pre-eclampsia. Ultrasound Obstet Gynecol 2019; 53 (01) 7-22
  • 4 Poon LC, Zymeri NA, Zamprakou A, Syngelaki A, Nicolaides KH. Protocol for measurement of mean arterial pressure at 11-13 weeks' gestation. Fetal Diagn Ther 2012; 31 (01) 42-48
  • 5 Rolnik DL, Wright D, Poon LC. et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med 2017; 377 (07) 613-622
  • 6 Poon LC, Wright D, Rolnik DL. et al. Aspirin for evidence-based preeclampsia prevention trial: effect of aspirin in prevention of preterm preeclampsia in subgroups of women according to their characteristics and medical and obstetrical history. Am J Obstet Gynecol 2017; 217 (05) 585.e1-585.e5 Erratum in: Am J Obstet Gynecol. 2018; PMID: 28784417
  • 7 Choorakuttil RM, Patel H, Bavaharan R. et al. Samrakshan: an Indian radiological and imaging association program to reduce perinatal mortality in India. Indian J Radiol Imaging 2019; 29 (04) 412-417
  • 8 Choorakuttil RM. The Samrakshan Screening Protocol for Pre-eclampsia in India – JFR [Internet]. 2020. Accessed Nov 24, 2022 at: https://fetalradiology.in/?p=3343
  • 9 Tolcher MC, Sangi-Haghpeykar H, Mendez-Figueroa H, Aagaard KM. Low-dose aspirin for preeclampsia prevention: efficacy by ethnicity and race. Am J Obstet Gynecol MFM 2020; 2 (04) 100184