Use of FMF algorithm for prediction of preeclampsia in high risk pregnancies: a single center longitudinal study

Cabunac, Petar; Orlić, Nataša Karadžov; Ardalić, Daniela; Pažin, B. Damnjanović; Stanimirović, Srđan; Banjac, Gorica; Stefanović, Aleksandra; Spasojević‐Kalimanovska, Vesna; Egić, Amira; Rajović, Nina; Milić, Nataša; Miković, Željko

doi:10.1080/10641955.2021.1921791

Cited by 4 publications

(6 citation statements)

References 46 publications

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“…This prediction model was established by the Fetal Medicine Foundation, and a revised algorithm using maternal characteristics and medical history, MAP, uterine artery PI, and serum PlGF identifies preterm PE with 75% sensitivity and EOPE with 90% sensitivity when the false positive rate is set at 10% [ 12 ]. It was also shown to be equally accurate in other cohort studies [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. We currently use this prediction model online ( [accessed 1 July 2022]).…”

Section: Introductionmentioning

confidence: 74%

Non-Coding RNAs and Prediction of Preeclampsia in the First Trimester of Pregnancy

Ogoyama

Takahashi

Suzuki

et al. 2022

Cells

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Preeclampsia (PE) is a major cause of maternal and perinatal morbidity and mortality. The only fundamental treatment for PE is the termination of pregnancy. Therefore, not only severe maternal complications but also perinatal complications due to immaturity of the infant associated with early delivery are serious issues. The treatment and prevention of preterm onset preeclampsia (POPE) are challenging. In 2017, the ASPRE trial showed that a low oral dose of aspirin administered to POPE high-risk women in early pregnancy reduced POPE by 62%. A prediction algorithm at 11–13 weeks of gestation identifies POPE with 75% sensitivity when the false positive rate is set at 10%. New biomarkers to increase the accuracy of the prediction model for POPE high-risk women in early pregnancy are needed. In this review, we focused on non-coding RNAs (ncRNAs) as potential biomarkers for the prediction of POPE. Highly expressed ncRNAs in the placenta in early pregnancy may play crucial roles in placentation. Furthermore, placenta-specific ncRNAs have been detected in maternal blood. In this review, we summarized ncRNAs that were highly expressed in the primary human placenta in early pregnancy. We also presented highly expressed ncRNAs in the placenta that were associated with or predictive of the development of PE in an expression analysis of maternal blood during the first trimester of pregnancy. These previous studies showed that the chromosome 19 microRNA (miRNA) -derived miRNAs (e.g., miR-517-5p, miR-518b, and miR-520h), the hypoxia-inducible miRNA (miR-210), and long non-coding RNA H19, were not only highly expressed in the early placenta but were also significantly up-regulated in the blood at early gestation in pregnant women who later developed PE. These maternal circulating ncRNAs in early pregnancy are expected to be possible biomarkers for POPE.

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Section: Introductionmentioning

confidence: 74%

Non-Coding RNAs and Prediction of Preeclampsia in the First Trimester of Pregnancy

Ogoyama

Takahashi

Suzuki

et al. 2022

Cells

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“…The most commonly used algorithm was established by FMF, which combined maternal risk factors, MAP, UtA‐PI, PlGF with or without sFlt‐1. Although it seems to outperform the traditional risk‐factor screening approach in the prediction of PE, when screening high‐risk pregnant women, the FMF algorithm presented low sensitivity (35%) 15 . In addition, the prediction performance of the FMF model is even lower when applied to populations other than the original population from which they were derived 26 .…”

Section: Discussionmentioning

confidence: 95%

“…Although it seems to outperform the traditional risk-factor screening approach in the prediction of PE, when screening high-risk pregnant women, the FMF algorithm presented low sensitivity (35%). 15 In addition, the prediction performance of the FMF model is even lower when applied to populations other than the original population from which they were derived. 26 Taken together, despite the investigation of numerous markers and algorithms, a reliable prediction model for PE has not been established.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 However, the overall accuracy of FMF score remained modest during all pregnancy trimesters (70%-80%). 15 Taken together, although many studies have been reported on the prediction of PE, no definitive predictive model with appropriately high accuracy is currently in widespread clinical use. 16 Fibronectin (FN) is a major component of the extracellular matrix and body fluids.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, Fetal Medicine Foundation (FMF) proposed an algorithm to combine maternal risk factors, MAP, uterine artery pulsatility index (UtA‐PI)), angiogenic markers (PlGF with or without sFlt‐1), in order to improve the detection rate of pregnancies at risk for PE 13,14 . However, the overall accuracy of FMF score remained modest during all pregnancy trimesters (70%–80%) 15 . Taken together, although many studies have been reported on the prediction of PE, no definitive predictive model with appropriately high accuracy is currently in widespread clinical use 16 …”

Section: Introductionmentioning

confidence: 99%

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Predictive value of the second‐trimester fibronectin concentration for severe preeclampsia: A prospective nested case–control study in China

Lin

Chen

et al. 2022

J of Obstet and Gynaecol

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Aim To evaluate the value of the second‐trimester fibronectin concentration, alone and in combination with other markers (e.g., mean arterial pressure, inhibin A), in the identification of women who subsequently develop severe preeclampsia. Methods For this prospective nested case–control study, serum from pregnant women (gestational age 15–22 weeks) who underwent routine Down syndrome screening was analyzed. The women were tracked to delivery and assigned to the severe preeclampsia or control group, according to whether they developed severe preeclampsia. Each woman who later developed severe preeclampsia was paired with five healthy women with pregnancies of similar gestational age (± 1 week). Fibronectin, inhibin A, human chorionic gonadotropin, placental growth factor, cysteine, and homocysteine concentrations were measured in 44 cases in the severe preeclampsia group and 220 cases in the control group. The body mass index and mean arterial pressure were calculated. All results were compared between the two groups. Logistic regression analysis and receiver operating characteristic curve construction were conducted for markers differing significantly between two groups. Results The second‐trimester fibronectin value was positively correlated with severe preeclampsia and predicted 67.7% of severe preeclampsia cases. The combination of fibronectin, inhibin A, and mean arterial pressure predicted 76.7% of severe preeclampsia cases; predictive values for combinations of fibronectin with mean arterial pressure or inhibin A were 75.4% and 74.6%, respectively. Combination with these other markers increased the predictive value of fibronectin. In addition, fibronectin was more powerful for the late severe preeclampsia and severe preeclampsia without fetal growth restriction subgroups. Conclusions The second‐trimester fibronectin concentration can be used to predict severe preeclampsia.

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First trimester screening and prediction of preeclampsia by Application of Fetal Medicine Foundation Algorithm at Tanta University

Ismail¹,

Hamamy²,

Abdallah³

et al. 2023

Int. J. Clin. Obstet. Gynaecol.

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Background: Preeclampsia (PE) is a complex illness linked to conception that affects a variety of bodily functions and is usually connected with perinatal morbidity and deaths. Early PE anticipation will reduce this linked morbidity and death by allowing for routine maternal and foetal monitoring and the use of preventative measures. Aim of the work: the goal of this study is to investigate whether the measurement of maternal serum placental growth factor (PlGF) combined with uterine artery Doppler ultrasound, are useful in early predicting PE and to examine the diagnostic accuracy of the Fetal Medicine Foundation (FMF) Algorithm for the early screening and anticipation of the high-risk PE at 11-13 weeks conception in a group of pregnant women. Patients and Methods: one hundred and twenty primigravida women with living, singleton fetus at 11-13 weeks conception without risk factors other than being primigravida attending antenatal care clinic at the Department of Obstetrics and Gynecology at Tanta University Hospitals. All cases were subjected to ; A signed informed written consent, proper history taking, full clinical examination, estimation of body mass index (BMI), blood pressures and determination of mean arterial blood pressure (MAP), ultrasound, Uterine artery doppler ultrasound examination with the determination of the mean Pulsatility index (PI) of the uterine arteries. Maternal serum levels of PlGF were also measured by specific immunoassay (ELISA). The measured values of MAP, mean uterine artery pulsatility index (PI) and PlGF were converted into multiples of the median (MoM). Then the FMF model was used for the determination of patient-specific risk of PE at 11-13 weeks conception in each case. Results:The main results of the present study revealed that; Only 11 of 120 normal pregnant women were categorized as a high PE risk with a percentage of 9.2% and the rest 109 cases were low PE risk with a percentage of 90.8% by application of FMF algorithm. There was a significant difference between the high and low risks regarding the mean uterian UtA-Pi and PIGF levels at 11-13 weeks. Receiver operating characteristic curve (ROC) demonstrate to what extent it can be depended on PlGF, mean UtA-PI and MAP as a predictor for PE denoting the significant diagnostic performance for PIGF and mean uterine artery pulsatility index (PI). The optimal cutoff value of PlGF value using the ROC curve was ≤40 leading to a sensitivity of 90.91%, a specificity of 96.33%, a PPV of 71.4, a NPV of 99.1% and an accuracy of 95.83%. While the optimal cutoff measure of mean uterine artery PI value using the ROC curve was >1.91 leading to a sensitivity of 90.91%, a specificity of 96.33%, PPV of 71.4, NPV of 99.1% and an accuracy of 95.83%. Conclusion:On the basis of these results, it could be concluded that the combined measurement of maternal serum PlGF concentrations and mean PI of the uterine arteries at 11-13 weeks of conception may help to predict the high-risk PE in primigravida when other parameters of PE anticipation are norm...

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Use of FMF algorithm for prediction of preeclampsia in high risk pregnancies: a single center longitudinal study

Cited by 4 publications

References 46 publications

Non-Coding RNAs and Prediction of Preeclampsia in the First Trimester of Pregnancy

Non-Coding RNAs and Prediction of Preeclampsia in the First Trimester of Pregnancy

Predictive value of the second‐trimester fibronectin concentration for severe preeclampsia: A prospective nested case–control study in China

First trimester screening and prediction of preeclampsia by Application of Fetal Medicine Foundation Algorithm at Tanta University

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