Objective: The purpose of this study was to evaluate the strategy of screening for preeclampsia
(PE) in the first trimester based on maternal characteristics, and estimated placental volume
(EPV).
Methods: A prospective cohort study was performed with 351 women enrolled, of which 13
women developed PE. This study analyzed the risk of PE according to ultrasonography findings
of the placenta, maternal characteristics, and serum markers. The placental ultrasound exam and
maternal serum pregnancy-associated plasma protein A (PAPP-A) was determined at 11þ0 to
13þ6weeks and the serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin (hCG),
unconjugated estriol (uE3), and inhibin A were assayed at 14þ0 to 22þ0weeks. We reviewed all
antenatal medical screening records and assessed the relationships of EPV of ultrasound examination,
maternal characteristics, and serum markers by using multiple logistic regression analysis.
Results: Thirteen of the 351 women (3.7%) developed PE in singleton pregnancy. The gestational
age at delivery was significantly different between the normal and PE group (p<.001). In
the PE group, the placental weight at delivery was not statistically different between the normal
and the PE group. The EPV at the first trimester was significantly lower in women with PE compared
to those without PE (p¼.002). In addition, we predicted PE using combined maternal
age, BMI, and EPV, which were achieving an area under the curve of 0.83 overall.
Conclusion: A risk prediction model of PE, which combined maternal age, BMI, and EPV can be
adopted for the screening of PE at the first trimester in singleton pregnancy