Eran Bornstein, MD explains the need for first trimester preeclampsia screening

In a recent interview with Contemporary OB/GYN, Eran Bornstein, MD, director of obstetrics and gynecology at Northwell’s Lenox Hill Hospital, discussed the importance of early detection and targeted prevention strategies to reduce the risks associated with preeclampsia.

Preeclampsia is a serious pregnancy complication affecting 5% to 10% of pregnant women and is a major cause of maternal and fetal morbidity and mortality. A comprehensive first-trimester screening protocol offers the most effective method for identifying women at high risk of developing early preeclampsia, defined as occurring before 37 weeks of gestation.

This first-trimester screening includes a combination of maternal characteristics, biophysical markers, and serum biomarkers. When integrated, these factors create a highly individualized risk assessment. This comprehensive screening detects over 80% of preeclampsia cases before 37 weeks' gestation and more than 90% of cases before 32 weeks, making it significantly more effective than traditional risk-factor-based assessments, which are less specific and result in high false-positive rates.

The test has been validated through large-scale international studies involving tens of thousands of women across various populations, ethnicities, and geographic areas. These studies support the test’s reliability and efficacy, leading many international health organizations to recommend it as the gold standard for preeclampsia screening.

A key benefit of early detection is the potential for effective intervention. Bornstein highlighted low-dose aspirin as a simple and effective treatment for reducing the incidence of preeclampsia, especially when administered to high-risk women identified through first-trimester screening. Aspirin has been shown to significantly reduce the risk of preeclampsia before both 37 and 32 weeks of gestation.

Clinicians can integrate this comprehensive screening into standard first-trimester visits. At that time, patients typically undergo assessments for fetal chromosomal abnormalities such as Down syndrome using nuchal translucency ultrasound and blood tests. By adding uterine artery Doppler measurements, maternal blood pressure, and a thorough medical history, providers can simultaneously screen for preeclampsia risk.

This approach transforms the first-trimester visit into a holistic evaluation of maternal and fetal health, enhancing early identification and prevention strategies for several complications. Bornstein advocated for broader implementation of this model, which is already in use at institutions such as Lenox Hill Hospital.

Disclosures: Longeviti Neuro Solutions LLC

This video is part 1 of a 2-part series. Check back tomorrow for part 2.