Screening auf Präeklampsie und Frühgeburt im ersten und zweiten Trimester

Preeclampsia and preterm birth are the main causes of perinatal and maternal morbidity and mortality. In addition to indicating intensified monitoring, early detection of women with an increased risk enables initiation of prophylactic measures. Preeclampsia screening should ideally be carried out in the first trimester using a combination of different markers, as this has the best predictive value for an early complication, therefore allowing the only effective prophylaxis—low-dose aspirin—to be initiated in good time. Individual markers (especially anamnestic factors) do not achieve these predictive values. In the further course of pregnancy, a prediction of hypertensive pregnancy complications can be achieved in the second and third trimester by using the multimarker algorithm. In contrast to preeclampsia screening, there is currently no multifactorial algorithm available for screening or predicting premature birth. The most important parameters are maternal obstetric history and the measurement of cervical length in the second trimester.