Prediction of Preeclampsia and Other Pregnancy Complications Following Combined Iterative Screening
Prediction of Preeclampsia and Other Pregnancy Complications Following Combined Iterative Screening
Preterm birth (PTB), preeclampsia (PE), fetal growth restriction (FGR) and intra-uterine
 fetal death (IUFD) constitutes the main causes of perinatal morbidity and mortality and are
 called "Great Obstetrical Syndromes". Algorithms to predict those outcomes have been
 developed by combining maternal characteristics (history, age, BMI, blood pressure),
 biochemical (sFlt-1, β-hCG, PlGF, AFP) and sonographic (uterine artery Doppler, 3D of
 placenta, cervical length, nasal bone measurement, nuchal translucency) markers. Another
 prospective observational study ("PREDICTION study" NCT 02189148) is also ongoing, which aims
 to validate those algorithms at the first trimester of pregnancy.

 Recent data suggest that repeating the same measurements later in pregnancy could improve the
 detection rates, allowing closer monitoring of high-risk patients and potential therapeutics
 under investigation. The current study (PREDICTION2) is an ancillary study of PREDICTION and
 aims at validating the use of these markers in a combined iterative manner in the prediction
 of preeclampsia and other obstetrical outcomes.
The objective of this study is to validate the predictive values of biophysical (maternal
 blood pressure); biochemical (sFlt-1, β-hCG, PlGF, and AFP) and ultrasonographic (cervical
 length, Doppler, 3D evaluation of the placenta, 3D nasal bone) biomarkers at several
 timepoints for the prediction of adverse pregnancy outcomes including preterm birth,
 preeclampsia, fetal growth restriction and intra-uterine fetal death.

 These biomarkers will be evaluated at 14-16 weeks, 20-24 weeks and 30-34 weeks. Those
 specific gestational ages have been selected because they correspond to the typical
 clinical/hospital visits for prenatal blood and/or ultrasound screening.
Inclusion Criteria:

 -  nulliparous pregnant women participating in Prediction study (NCT02189148)

 Exclusion Criteria:

 -  <18 years old at recruitment;

 -  multiple pregnancies;

 -  fetal congenital malformation;

 -  positive for HIV or hepatitis C;

 -  fetal demise at recruitment;

 -  women planning a delivery outside the participating hospitals;

 -  women not able to provide an informed consent to the study.