TY  - BOOK
AU  - Halscott, Torre L
AU  - Ramsey, Patrick S
AU  - Reddy, Uma M
TI  - First trimester screening cannot predict adverse outcomes yet. [Review]
SN  - 0197-3851
KW  - *Pregnancy Complications/di [Diagnosis]
KW  - *Pregnancy Trimester, First
KW  - *Prenatal Diagnosis
KW  - Biological Markers/bl [Blood]
KW  - Female
KW  - Humans
KW  - Predictive Value of Tests
KW  - Pregnancy
KW  - Pregnancy Complications/bl [Blood]
KW  - Pregnancy Outcome
KW  - Pregnancy Trimester, First/bl [Blood]
KW  - Prenatal Diagnosis/mt [Methods]
KW  - Prenatal Diagnosis/st [Standards]
KW  - Prognosis
KW  - Time Factors
KW  - MedStar Washington Hospital Center
KW  - Obstetrics and Gynecology, Maternal-Fetal Medicine
KW  - Journal Article
KW  - Review
N2  - The use of first trimester screening to detect aneuploidy has become an integral part of prenatal care. The application of similar screening algorithms to identify women at the highest risk for other adverse pregnancy outcomes in the first trimester could potentially have a major clinical impact. There has been much investigation into the ability to identify patients early in pregnancy at high risk for adverse pregnancy outcomes who may benefit from further surveillance and/or intervention. For this to be the case, however, as is true of any useful screening test, effective interventions need to be available. Unfortunately, for fetal growth restriction and stillbirth, no such interventions exist short of delivery. For preeclampsia, low dose aspirin has been demonstrated to be of benefit in specific subgroups. For preterm birth, although there are efficacious treatments, first trimester serum markers or cervical length measurements do not add significantly beyond historical or demographic factors, in prediction of preterm birth. Given the current evidence, first trimester screening, via serum or ultrasound markers, does not have sufficiently high enough positive predictive values for the development of preeclampsia, fetal growth restriction, preterm birth or stillbirth. In order to develop effective screening algorithms for adverse pregnancy outcomes in the first trimester, understanding the heterogeneous phenotype of these complications and the underlying pathophysiology is needed.Copyright � 2014 John Wiley & Sons, Ltd
UR  - http://dx.doi.org/10.1002/pd.4407
ER  -